1. Behavioral Health Provider Update

2. Overview Upcoming changes for providers: What’s new & Who it effects Coding/Billing Information Credentialing/Enrollment

3. FOR BEHAVIORAL HEALTH PROVIDERS What’s New

4. Bulletin: MSA 15-44 Michigan Department of Health and Human Services (MDHHS) has begun enrolling behavioral health providers to the Medicaid program. “Fee-for-service outpatient behavioral health visits will be increased from 10 to a maximum of 20 combined visits in a 12- month period, per beneficiary, by all providers of behavioral health services.”

5. What’s new? January 1 st, 2016, Behavioral Health provider will be able to bill Medicaid of Michigan for services. Link to Bulletin MSA 15-44: www.michigan.gov/documents/mdhhs/msa_15-44_504790_7.pdf December 1 st, 2015, provider enrollment began. www.michigan.gov/medicaidproviders Provider Support: 1-800-292-2550 **Enrollment as a provider is done through CHAMPS with MDHHS. You must set up a user account before going forward with provider enrollment. Please use above link to access CHAMPS**

6. Who is eligible? Psychologists (Master’s Limited or Doctoral Level) Social Workers (Master’s Level) Professional Counselors (Master’s or Doctoral levels) **Limited licensed psychologists, social workers, professional counselors or student interns must be overseen by enrolled, fully- licensed provider of the same profession**

7. Who Is Eligible? Student Interns See Bulletin MSA 15-44 Tribal Health Centers See Bulletin MSA 15-44

8. WHO IS ELIGIBLE Questions

9. PROCESS Coding & Billing

10. Behavioral Health CPT Codes Access full code list at: www.scha-mi.org/events CPT CodeCode Description Max Fee 90785 Add-on code to be used in conjunction with codes for primary service: $9.11 psychiatric diagnostic evaluation (90791); psychotherapy (90832, 90834, 90837); and group psychotherapy (90853) 90791 Psychiatric diagnostic evalaution $72.31 90832 Psychotherapy, 30 minutes with patient and/or family member30 minutes $36.05 90834 Psychotherapy, 45 minutes with patient and/or family member45 minutes $47.35 90837 Psychotherapy, 60 minutes with patient and/or family member60 minutes $70.13 90839 Psychotherapy for crisis, first 60 minutes 60 minutes $73.50 90840 Add on for each additional 30 minutes of psychotherapy for crisis, usedeach additional $35.26 in conjunction with code 90839 30 minutes 90847 Family psychotherapy, with patient present $59.03 90853 Group psychotherapy $14.26

11. How to Use Codes Actual length of sessionCode AsCode DescriptionMax Fee 0-15 minutesNot reported 16-37 minutes90832 30 minutes (with patient and/or family member) $36.05 38-52 minutes90834 45 minutes (with patient and/or family member) $47.35 53-89 minutes90837 60 minutes (with patient and/or family member) $70.13 Group Psychotherapy90853 $14.26

12. How to use Codes cont.

13. Billing Electronically accepted Professional format ASC X12N 837 5010 CMS 1500 paper claims See manual for specifics on submitting Manual: www.michigan.gov/medicaidproviderswww.michigan.gov/medicaidproviders ~Policy and Forms ~Medicaid Provider Manual

14. CODING & BILLING Questions

15. PROCESS Credentialing & Enrollment

16. Credentialing Credentialing & Enrollment ~Identification/verification of all required documents and information ~Facility and/or group ~Practitioner ~Creation/update of practitioner’s Council for Affordable Quality Healthcare [CAQH] file ~Identification of geographic area’s insurance payers ~Registration & enrollment with identified payers ~Continued attestation of CAQH and payer enrollments/credentialing

17. Enrollment Enrollment with Medicaid of Michigan www.michigan.gov/medicaidproviders ~Scroll down under Hot Topics and click on Champs icon ~Single Sign On (SSO) Sign Up for user access Access Information emailed ~Start enrollment process MDHHS Provider Support: 1-800-292-2550

18. CREDENTIALING & ENROLLMENT Questions

19. Review January 1 st, 2016 start providing behavioral health services December 1, 2015, enrollment began Credentialing/Enrollment Who is eligible: Psychologists (Master’s Limited or Doctoral Level) Social Workers (Master’s Level) Professional Counselors (Master’s or Doctoral levels)

20. Useful Information www.michigan.gov/medicaidproviders www.michigan.gov/documents/mdhhs/msa_15- 44_504790_7.pdf www.michigan.gov/documents/mdhhs/msa_15- 44_504790_7.pdf MDHHS Provider Support: 1-800-292-2550 www.scha-mi.org/events

21. Resources  (2013, March 7 th ). National Council For Community Behavioral Healthcare. Retrieved from http://www.thenationalcouncil.org/wp- content/uploads/2013/06/NC-CPT-FAQ-for-2013- V3.pdf. http://www.thenationalcouncil.org/wp- content/uploads/2013/06/NC-CPT-FAQ-for-2013- V3.pdf  MSA Bulletin. (2015, October 30). Retrieved from www.michigan.gov/documents/mdhhs/msa_15- 44_504790_7.pdf. www.michigan.gov/documents/mdhhs/msa_15- 44_504790_7.pdf

22. Thank You 6035 Executive Drive Suite 103 Lansing, Michigan 48911 Phone: 517-908-0847 Fax: 517-908-0826 Website: www.scha-mi.org