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Modifier 1 AF AM U3 SA AH AJ U8 U8 HO HO HO HO HO U4 U4 U4 U4 U4 U4 U1 U2Practitioner PSYTRST MD/DO PSY RES APRN PSYGST LCSW LPP LPA LPCC LMFT LPAT LBA LCADC CSW LPCA MFTA LPATA LABA LCADCA PA Psy RNModifier 1 TD HN U5 U6 U7 UC UD U9
Practitioner RN PE MHA CADC PSS CSAPreg. Wom PERDIM
CMHC Mental Health Substance Abuse Fee Schedule (Rev. 6/1/16)
Modifier 1 AF AM U3 SA AH AJ U8 U8 HO HO HO HO HO U4 U4 U4 U4 U4 U4 U1 U2Practitioner PSYTRST MD/DO PSY RES APRN PSYGST LCSW LPP LPA LPCC LMFT LPAT LBA LCADC CSW LPCA MFTA LPATA LABA LCADCA PA Psy RNModifier 1 TD HN U5 U6 U7 UC UD U9
Practitioner RN PE MHA CADC PSS CSAPreg. Wom PERDIM
CMHC Mental Health Substance Abuse Fee Schedule (Rev. 6/1/16)
Modifier 1 AF AM U3 SA AH AJ U8 U8 HO HO HO HO HO U4 U4 U4 U4 U4 U4 U1 U2Practitioner PSYTRST MD/DO PSY RES APRN PSYGST LCSW LPP LPA LPCC LMFT LPAT LBA LCADC CSW LPCA MFTA LPATA LABA LCADCA PA Psy RNModifier 1 TD HN U5 U6 U7 UC UD U9
Practitioner RN PE MHA CADC PSS CSAPreg. Wom PERDIM
CMHC Mental Health Substance Abuse Fee Schedule (Rev. 6/1/16)
Modifier 1 AF AM U3 SA AH AJ U8 U8 HO HO HO HO HO U4 U4 U4 U4 U4 U4 U1 U2Practitioner PSYTRST MD/DO PSY RES APRN PSYGST LCSW LPP LPA LPCC LMFT LPAT LBA LCADC CSW LPCA MFTA LPATA LABA LCADCA PA Psy RNModifier 1 TD HN U5 U6 U7 UC UD U9
Practitioner RN PE MHA CADC PSS CSAPreg. Wom PERDIM
CMHC Mental Health Substance Abuse Fee Schedule (Rev. 6/1/16)
Modifier 1 AF AM U3 SA AH AJ U8 U8 HO HO HO HO HO U4 U4 U4 U4 U4 U4 U1 U2Practitioner PSYTRST MD/DO PSY RES APRN PSYGST LCSW LPP LPA LPCC LMFT LPAT LBA LCADC CSW LPCA MFTA LPATA LABA LCADCA PA Psy RNModifier 1 TD HN U5 U6 U7 UC UD U9
Practitioner RN PE MHA CADC PSS CSAPreg. Wom PERDIM
CMHC Mental Health Substance Abuse Fee Schedule (Rev. 6/1/16)
Modifier 1 AF AM U3 SA AH AJ U8 U8 HO HO HO HO HO U4 U4 U4 U4 U4 U4 U1 U2Practitioner PSYTRST MD/DO PSY RES APRN PSYGST LCSW LPP LPA LPCC LMFT LPAT LBA LCADC CSW LPCA MFTA LPATA LABA LCADCA PA Psy RNModifier 1 TD HN U5 U6 U7 UC UD U9
Practitioner RN PE MHA CADC PSS CSAPreg. Wom PERDIM
CMHC Mental Health Substance Abuse Fee Schedule (Rev. 6/1/16)
Procedure Code U
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Procedure Code Description90899 Unlisted psychiatric service or procedure Event U4 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.8090899 Unlisted psychiatric service or procedure Event U1 124.36 160.04 144.00 151.20 140.00 129.40 84.00 191.72 134.00 170.00 127.48 135.16 98.92 136.0090899 Unlisted psychiatric service or procedure Event U2 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.8090899 Unlisted psychiatric service or procedure Event TD 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.8090899 Unlisted psychiatric service or procedure Event HN 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.8090899 Unlisted psychiatric service or procedure Event U5 113.64 106.00 81.40 82.24 108.68 80.60 80.44 94.00 78.08 108.52 113.60 94.52 86.92 102.2090899 Unlisted psychiatric service or procedure Event U6 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.8096101 Psychological Testing by Psych/Phys 60 Min. AH 187.34 208.62 182.17 143.14 217.94 148.00 114.51 217.26 172.75 204.03 190.09 193.32 154.36 176.0296101 Psychological Testing by Psych/Phys 60 Min. U8 176.32 196.35 171.46 134.72 205.12 139.30 107.78 204.48 162.59 192.03 178.91 181.95 145.28 165.6696102 Psychoogical Testing administered by a technician 60 Min AH 38.24 38.24 38.24 38.24 38.24 38.24 38.24 38.24 38.24 38.24 38.24 38.24 38.24 38.2496102 Psychological Testing administered by a technician 60 Min. U8 35.99 35.99 35.99 35.99 35.99 35.99 35.99 35.99 35.99 35.99 35.99 35.99 35.99 35.9996103 Psychological Testing administered by a computer 60 Min. AH 16.96 16.96 16.96 16.96 16.96 16.96 16.96 16.96 16.96 16.96 16.96 16.96 16.96 16.9696103 Psychological Testing administered by a computer 60 Min. U8 15.96 15.96 15.96 15.96 15.96 15.96 15.96 15.96 15.96 15.96 15.96 15.96 15.96 15.9696105 Assessment of Aphasia, per hour 60 Min. AF 72.45 72.45 72.45 72.45 72.45 72.45 72.45 72.45 72.45 72.45 72.45 72.45 72.45 72.4596105 Assessment of Aphasia, per hour 60 Min AM 72.45 72.45 72.45 72.45 72.45 72.45 72.45 72.45 72.45 72.45 72.45 72.45 72.45 72.4596105 Assessment of Aphasia, per hour 60 Min U3 72.45 72.45 72.45 72.45 72.45 72.45 72.45 72.45 72.45 72.45 72.45 72.45 72.45 72.4596105 Assessment of Aphasia, per hour 60 Min SA 61.58 61.58 61.58 61.58 61.58 61.58 61.58 61.58 61.58 61.58 61.58 61.58 61.58 61.5896105 Assessment of Aphasia, per hour 60 Min. AH 61.58 61.58 61.58 61.58 61.58 61.58 61.58 61.58 61.58 61.58 61.58 61.58 61.58 61.5896105 Assessment of Aphasia, per hour 60 Min. AJ 57.96 57.96 57.96 57.96 57.96 57.96 57.96 57.96 57.96 57.96 57.96 57.96 57.96 57.9696105 Assessment of Aphasia, per hour 60 Min. U8 57.96 57.96 57.96 57.96 57.96 57.96 57.96 57.96 57.96 57.96 57.96 57.96 57.96 57.9696105 Assessment of Aphasia, per hour 60 Min. HO 57.96 57.96 57.96 57.96 57.96 57.96 57.96 57.96 57.96 57.96 57.96 57.96 57.96 57.9696105 Assessment of Aphasia, per hour 60 Min. U4 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.7296105 Assessment of Aphasia, per hour 60 Min. U1 61.58 61.58 61.58 61.58 61.58 61.58 61.58 61.58 61.58 61.58 61.58 61.58 61.58 61.5896105 Assessment of Aphasia, per hour 60 Min. U2 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.7296105 Assessment of Aphasia, per hour 60 Min. HN 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.7296105 Assessment of Aphasia, per hour 60 Min. U5 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.72 50.7296110 Developmental Screening, per standardized instrument Event AF 32.19 32.19 32.19 32.19 32.19 32.19 32.19 32.19 32.19 32.19 32.19 32.19 32.19 32.1996110 Developmental Screening, per standardized instrument Event AM 32.19 32.19 32.19 32.19 32.19 32.19 32.19 32.19 32.19 32.19 32.19 32.19 32.19 32.1996110 Developmental Screening, per standardized instrument Event U3 32.19 32.19 32.19 32.19 32.19 32.19 32.19 32.19 32.19 32.19 32.19 32.19 32.19 32.1996110 Developmental Screening, per standardized instrument Event SA 27.36 27.36 27.36 27.36 27.36 27.36 27.36 27.36 27.36 27.36 27.36 27.36 27.36 27.3696110 Developmental Screening, per standardized instrument Event AH 27.36 27.36 27.36 27.36 27.36 27.36 27.36 27.36 27.36 27.36 27.36 27.36 27.36 27.3696110 Developmental Screening, per standardized instrument Event AJ 25.75 25.75 25.75 25.75 25.75 25.75 25.75 25.75 25.75 25.75 25.75 25.75 25.75 25.7596110 Developmental Screening, per standardized instrument Event U8 25.75 25.75 25.75 25.75 25.75 25.75 25.75 25.75 25.75 25.75 25.75 25.75 25.75 25.7596110 Developmental Screening, per standardized instrument Event HO 25.75 25.75 25.75 25.75 25.75 25.75 25.75 25.75 25.75 25.75 25.75 25.75 25.75 25.7596110 Developmental Screening, per standardized instrument Event U4 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.5396110 Developmental Screening, per standardized instrument Event U1 27.36 27.36 27.36 27.36 27.36 27.36 27.36 27.36 27.36 27.36 27.36 27.36 27.36 27.3696110 Developmental Screening, per standardized instrument Event U2 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.5396110 Developmental Screening, per standardized instrument Event HN 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.5396110 Developmental Screening, per standardized instrument Event U5 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.53 22.5396111 Developmental Testing w/ Interpretation and Rpt. Event AF 93.59 93.59 93.59 93.59 93.59 93.59 93.59 93.59 93.59 93.59 93.59 93.59 93.59 93.59
Modifier 1 AF AM U3 SA AH AJ U8 U8 HO HO HO HO HO U4 U4 U4 U4 U4 U4 U1 U2Practitioner PSYTRST MD/DO PSY RES APRN PSYGST LCSW LPP LPA LPCC LMFT LPAT LBA LCADC CSW LPCA MFTA LPATA LABA LCADCA PA Psy RNModifier 1 TD HN U5 U6 U7 UC UD U9
Practitioner RN PE MHA CADC PSS CSAPreg. Wom PERDIM
CMHC Mental Health Substance Abuse Fee Schedule (Rev. 6/1/16)
Modifier 1 AF AM U3 SA AH AJ U8 U8 HO HO HO HO HO U4 U4 U4 U4 U4 U4 U1 U2Practitioner PSYTRST MD/DO PSY RES APRN PSYGST LCSW LPP LPA LPCC LMFT LPAT LBA LCADC CSW LPCA MFTA LPATA LABA LCADCA PA Psy RNModifier 1 TD HN U5 U6 U7 UC UD U9
Practitioner RN PE MHA CADC PSS CSAPreg. Wom PERDIM
CMHC Mental Health Substance Abuse Fee Schedule (Rev. 6/1/16)
Procedure Code U
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Procedure Code Description96125 Standardized Cognitive Perf. Tesing, Qualified H C Prof. 60 Min. AF 80.63 80.63 80.63 80.63 80.63 80.63 80.63 80.63 80.63 80.63 80.63 80.63 80.63 80.6396125 Standardized Cognitive Perf. Tesing, Qualified H C Prof. 60 Min AM 80.63 80.63 80.63 80.63 80.63 80.63 80.63 80.63 80.63 80.63 80.63 80.63 80.63 80.6396125 Standardized Cognitive Perf. Tesing, Qualified H C Prof. 60 Min AH 68.54 68.54 68.54 68.54 68.54 68.54 68.54 68.54 68.54 68.54 68.54 68.54 68.54 68.5496125 Standardized Cognitive Perf. Tesing, Qualified H C Prof. 60 Min U3 80.63 80.63 80.63 80.63 80.63 80.63 80.63 80.63 80.63 80.63 80.63 80.63 80.63 80.6396125 Standardized Cognitive Perf. Tesing, Qualified H C Prof. 60 Min SA 68.54 68.54 68.54 68.54 68.54 68.54 68.54 68.54 68.54 68.54 68.54 68.54 68.54 68.5496125 Standardized Cognitive Perf. Tesing, Qualified H C Prof. 60 Min AJ 64.50 64.50 64.50 64.50 64.50 64.50 64.50 64.50 64.50 64.50 64.50 64.50 64.50 64.5096125 Standardized Cognitive Perf. Tesing, Qualified H C Prof. 60 Min U8 64.50 64.50 64.50 64.50 64.50 64.50 64.50 64.50 64.50 64.50 64.50 64.50 64.50 64.5096125 Standardized Cognitive Perf. Tesing, Qualified H C Prof. 60 Min HO 64.50 64.50 64.50 64.50 64.50 64.50 64.50 64.50 64.50 64.50 64.50 64.50 64.50 64.5096125 Standardized Cognitive Perf. Tesing, Qualified H C Prof. 60 Min U4 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.4496125 Standardized Cognitive Perf. Tesing, Qualified H C Prof. 60 Min U1 68.54 68.54 68.54 68.54 68.54 68.54 68.54 68.54 68.54 68.54 68.54 68.54 68.54 68.5496125 Standardized Cognitive Perf. Tesing, Qualified H C Prof. 60 Min U2 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.4496125 Standardized Cognitive Perf. Tesing, Qualified H C Prof. 60 Min HN 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.4496125 Standardized Cognitive Perf. Tesing, Qualified H C Prof. 60 Min U5 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.44 56.4496150 Health and Behavior Assessment; Initial Assessment 15 Min. AF 15.75 15.75 15.75 15.75 15.75 15.75 15.75 15.75 15.75 15.75 15.75 15.75 15.75 15.7596150 Health and Behavior Assessment; Initial Assessment 15 Min. AM 15.75 15.75 15.75 15.75 15.75 15.75 15.75 15.75 15.75 15.75 15.75 15.75 15.75 15.7596150 Health and Behavior Assessment; Initial Assessment 15 Min. U3 15.75 15.75 15.75 15.75 15.75 15.75 15.75 15.75 15.75 15.75 15.75 15.75 15.75 15.7596150 Health and Behavior Assessment; Initial Assessment 15 Min. SA 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.3996150 Health and Behavior Assessment; Initial Assessment 15 Min. AH 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.3996150 Health and Behavior Assessment; Initial Assessment 15 Min. AJ 12.60 12.60 12.60 12.60 12.60 12.60 12.60 12.60 12.60 12.60 12.60 12.60 12.60 12.6096150 Health and Behavior Assessment; Initial Assessment 15 Min. U8 12.60 12.60 12.60 12.60 12.60 12.60 12.60 12.60 12.60 12.60 12.60 12.60 12.60 12.6096150 Health and Behavior Assessment; Initial Assessment 15 Min. HO 12.60 12.60 12.60 12.60 12.60 12.60 12.60 12.60 12.60 12.60 12.60 12.60 12.60 12.6096150 Health and Behavior Assessment; Initial Assessment 15 Min. U4 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.0396150 Health and Behavior Assessment; Initial Assessment 15 Min. U1 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.3996150 Health and Behavior Assessment; Initial Assessment 15 Min. U2 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.0396150 Health and Behavior Assessment; Initial Assessment 15 Min. TD 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.0396150 Health and Behavior Assessment; Initial Assessment 15 Min. HN 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.0396150 Health and Behavior Assessment; Initial Assessment 15 Min. U5 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.0396151 Health and Behavior Assessment; Reassessment 15 Min. AF 15.21 15.21 15.21 15.21 15.21 15.21 15.21 15.21 15.21 15.21 15.21 15.21 15.21 15.2196151 Health and Behavior Assessment; Reassessment 15 Min. AM 15.21 15.21 15.21 15.21 15.21 15.21 15.21 15.21 15.21 15.21 15.21 15.21 15.21 15.2196151 Health and Behavior Assessment; Reassessment 15 Min. U3 15.21 15.21 15.21 15.21 15.21 15.21 15.21 15.21 15.21 15.21 15.21 15.21 15.21 15.2196151 Health and Behavior Assessment; Reassessment 15 Min. SA 12.93 12.93 12.93 12.93 12.93 12.93 12.93 12.93 12.93 12.93 12.93 12.93 12.93 12.9396151 Health and Behavior Assessment; Reassessment 15 Min. AH 12.93 12.93 12.93 12.93 12.93 12.93 12.93 12.93 12.93 12.93 12.93 12.93 12.93 12.9396151 Health and Behavior Assessment; Reassessment 15 min. AJ 12.17 12.17 12.17 12.17 12.17 12.17 12.17 12.17 12.17 12.17 12.17 12.17 12.17 12.1796151 Health and Behavior Assessment; Reassessment 15 Min. U8 12.17 12.17 12.17 12.17 12.17 12.17 12.17 12.17 12.17 12.17 12.17 12.17 12.17 12.1796151 Health and Behavior Assessment; Reassessment 15 Min. HO 12.17 12.17 12.17 12.17 12.17 12.17 12.17 12.17 12.17 12.17 12.17 12.17 12.17 12.1796151 Health and Behavior Assessment; Reassessment 15 min. U4 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.0396151 Health and Behavior Assessment; Reassessment 15 Min. U1 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.39 13.3996151 Health and Behavior Assessment; Reassessment 15 Min. U2 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.0396151 Health and Behavior Assessment; Reassessment 15 Min. TD 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.0396151 Health and Behavior Assessment; Reassessment 15 Min. HN 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03
Modifier 1 AF AM U3 SA AH AJ U8 U8 HO HO HO HO HO U4 U4 U4 U4 U4 U4 U1 U2Practitioner PSYTRST MD/DO PSY RES APRN PSYGST LCSW LPP LPA LPCC LMFT LPAT LBA LCADC CSW LPCA MFTA LPATA LABA LCADCA PA Psy RNModifier 1 TD HN U5 U6 U7 UC UD U9
Practitioner RN PE MHA CADC PSS CSAPreg. Wom PERDIM
CMHC Mental Health Substance Abuse Fee Schedule (Rev. 6/1/16)
Procedure Code U
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Procedure Code Description96151 Health and Behavior Assessment; Reassessment 15 Min. U5 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.03 11.0399213 Evaluation and management of an established patient 15 Min. AF 55.10 61.36 53.58 42.10 64.10 43.53 33.68 63.90 50.81 60.01 55.91 56.86 45.40 51.7799213 Evaluation and management of an established patient 15 Min. AM 55.10 61.36 53.58 42.10 64.10 43.53 33.68 63.90 50.81 60.01 55.91 56.86 45.40 51.7799213 Evaluation and management of an established patient 15 Min. U3 32.47 30.29 26.39 23.50 31.57 23.03 22.98 31.47 25.03 31.01 32.46 28.01 24.83 29.2099213 Evaluation and management of an established patient 15 Min. SA 31.09 40.01 36.00 37.80 35.00 32.35 21.00 47.93 33.50 42.50 31.87 33.79 24.73 24.7399213 Evaluation and management of an established patient 15 Min. U1 33.79 36.00 24.73 21.00 24.73 32.35 35.00 47.93 40.01 42.50 31.67 33.50 37.80 31.0999354 Prolonged Services (First Hour, Use with 90837) 30-60 Min AF 71.39 71.39 71.39 71.39 71.39 71.39 71.39 71.39 71.39 71.39 71.39 71.39 71.39 71.3999354 Prolonged Services (First Hour, Use with 90837) 30-60 Min AM 71.39 71.39 71.39 71.39 71.39 71.39 71.39 71.39 71.39 71.39 71.39 71.39 71.39 71.3999354 Prolonged Services (First Hour, Use with 90837) 30-60 Min U3 71.39 71.39 71.39 71.39 71.39 71.39 71.39 71.39 71.39 71.39 71.39 71.39 71.39 71.3999354 Prolonged Services (First Hour, Use with 90837) 30-60 Min SA 60.68 60.68 60.68 60.68 60.68 60.68 60.68 60.68 60.68 60.68 60.68 60.68 60.68 60.6899354 Prolonged Services (First Hour, Use with 90837) 30-60 Min AH 60.68 60.68 60.68 60.68 60.68 60.68 60.68 60.68 60.68 60.68 60.68 60.68 60.68 60.6899354 Prolonged Services (First Hour, Use with 90837) 30-60 Min AJ 60.68 60.68 60.68 60.68 60.68 60.68 60.68 60.68 60.68 60.68 60.68 60.68 60.68 60.6899354 Prolonged Services (First Hour, Use with 90837) 30-60 Min U8 57.11 57.11 57.11 57.11 57.11 57.11 57.11 57.11 57.11 57.11 57.11 57.11 57.11 57.1199354 Prolonged Services (First Hour, Use with 90837) 30-60 Min HO 57.11 57.11 57.11 57.11 57.11 57.11 57.11 57.11 57.11 57.11 57.11 57.11 57.11 57.1199354 Prolonged Services (First Hour, Use with 90837) 30-60 Min U4 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.9799354 Prolonged Services (First Hour, Use with 90837) 30-60 Min U1 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.9799354 Prolonged Services (First Hour, Use with 90837) 30-60 Min U2 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.9799354 Prolonged Services (First Hour, Use with 90837) 30-60 Min HN 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.9799354 Prolonged Services (First Hour, Use with 90837) 30-60 Min U5 43.97 43.97 43.97 43.97 43.97 43.97 43.97 43.97 43.97 43.97 43.97 43.97 43.97 43.9799354 Prolonged Services (First Hour, Use with 90837) 30-60 Min U6 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.97 49.9799355 Prolonged Services (After 60 minutes of prolonged) 15-30 Min AF 69.99 69.99 69.99 69.99 69.99 69.99 69.99 69.99 69.99 69.99 69.99 69.99 69.99 69.9999355 Prolonged Services (After 60 minutes of prolonged) 15-30 Min AM 69.99 69.99 69.99 69.99 69.99 69.99 69.99 69.99 69.99 69.99 69.99 69.99 69.99 69.9999355 Prolonged Services (After 60 minutes of prolonged) 15-30 Min U3 69.99 69.99 69.99 69.99 69.99 69.99 69.99 69.99 69.99 69.99 69.99 69.99 69.99 69.9999355 Prolonged Services (After 60 minutes of prolonged) 15-30 Min SA 59.49 59.49 59.49 59.49 59.49 59.49 59.49 59.49 59.49 59.49 59.49 59.49 59.49 59.4999355 Prolonged Services (After 60 minutes of prolonged) 15-30 Min AH 59.49 59.49 59.49 59.49 59.49 59.49 59.49 59.49 59.49 59.49 59.49 59.49 59.49 59.4999355 Prolonged Services (After 60 minutes of prolonged) 15-30 Min AJ 55.99 55.99 55.99 55.99 55.99 55.99 55.99 55.99 55.99 55.99 55.99 55.99 55.99 55.9999355 Prolonged Services (After 60 minutes of prolonged) 15-30 Min U8 55.99 55.99 55.99 55.99 55.99 55.99 55.99 55.99 55.99 55.99 55.99 55.99 55.99 55.9999355 Prolonged Services (After 60 minutes of prolonged) 15-30 Min HO 55.99 55.99 55.99 55.99 55.99 55.99 55.99 55.99 55.99 55.99 55.99 55.99 55.99 55.9999355 Prolonged Services (After 60 minutes of prolonged) 15-30 Min U4 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.9999355 Prolonged Services (After 60 minutes of prolonged) 15-30 Min U1 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.9999355 Prolonged Services (After 60 minutes of prolonged) 15-30 Min U2 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.9999355 Prolonged Services (After 60 minutes of prolonged) 15-30 Min HN 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.9999355 Prolonged Services (After 60 minutes of prolonged) 15-30 Min U5 43.11 43.11 43.11 43.11 43.11 43.11 43.11 43.11 43.11 43.11 43.11 43.11 43.11 43.1199355 Prolonged Services (After 60 minutes of prolonged) 15-30 Min U6 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.99 48.9999408 Alcohol and.or substance abuse structured screening and b 15-30 Min. AF 110.20 122.72 107.16 84.20 128.20 87.06 67.36 127.80 101.62 120.02 111.82 113.72 90.80 103.5499408 Alcohol and or substance abuse structured screening and br 15-30 Min. AM 64.94 60.58 46.52 47.00 62.10 46.06 45.96 53.72 44.62 62.02 64.92 54.02 49.66 58.4099408 Alcohol and or substance abuse structured screening and br 15-30 Min. U3 64.94 60.58 52.78 47.00 63.15 46.06 45.96 62.95 50.05 62.02 64.92 56.01 49.66 58.4099408 Alcohol and or substance abuse structured screening and br 15-30 Min. SA 62.18 80.02 72.00 75.60 70.00 64.70 42.00 95.86 67.00 85.00 63.74 67.58 49.46 68.0099408 Alcohol and or substance abuse structured screening and br 15-30 Min. AH 64.94 60.58 46.52 47.00 62.10 46.06 45.96 53.72 44.62 62.02 64.92 54.02 49.66 58.4099408 Alcohol and or substance abuse structured screening and br 15-30 Min. AJ 64.94 60.58 46.52 47.00 62.10 46.06 45.96 53.72 44.62 62.02 64.92 54.02 49.66 58.40
Modifier 1 AF AM U3 SA AH AJ U8 U8 HO HO HO HO HO U4 U4 U4 U4 U4 U4 U1 U2Practitioner PSYTRST MD/DO PSY RES APRN PSYGST LCSW LPP LPA LPCC LMFT LPAT LBA LCADC CSW LPCA MFTA LPATA LABA LCADCA PA Psy RNModifier 1 TD HN U5 U6 U7 UC UD U9
Practitioner RN PE MHA CADC PSS CSAPreg. Wom PERDIM
CMHC Mental Health Substance Abuse Fee Schedule (Rev. 6/1/16)
Modifier 1 AF AM U3 SA AH AJ U8 U8 HO HO HO HO HO U4 U4 U4 U4 U4 U4 U1 U2Practitioner PSYTRST MD/DO PSY RES APRN PSYGST LCSW LPP LPA LPCC LMFT LPAT LBA LCADC CSW LPCA MFTA LPATA LABA LCADCA PA Psy RNModifier 1 TD HN U5 U6 U7 UC UD U9
Practitioner RN PE MHA CADC PSS CSAPreg. Wom PERDIM
CMHC Mental Health Substance Abuse Fee Schedule (Rev. 6/1/16)
Modifier 1 AF AM U3 SA AH AJ U8 U8 HO HO HO HO HO U4 U4 U4 U4 U4 U4 U1 U2Practitioner PSYTRST MD/DO PSY RES APRN PSYGST LCSW LPP LPA LPCC LMFT LPAT LBA LCADC CSW LPCA MFTA LPATA LABA LCADCA PA Psy RNModifier 1 TD HN U5 U6 U7 UC UD U9
Practitioner RN PE MHA CADC PSS CSAPreg. Wom PERDIM
CMHC Mental Health Substance Abuse Fee Schedule (Rev. 6/1/16)
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Procedure Code DescriptionH0025 Alcohol and/or Drug Prevention Event AF 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04H0025 Alcohol and/or Drug Prevention Event AM 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04H0025 Alcohol and/or Drug Prevention Event U3 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04H0025 Alcohol and/or Drug Prevention Event SA 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04H0025 Alcohol and/or Drug Prevention Event AH 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04H0025 Alcohol and/or Drug Prevention Event AJ 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04H0025 Alcohol and/or Drug Prevention Event U8 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04H0025 Alcohol and/or Drug Prevention Event HO 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04H0025 Alcohol and/or Drug Prevention Event U4 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04H0025 Alcohol and/or Drug Prevention Event U1 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04H0025 Alcohol and/or Drug Prevention Event U2 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04H0025 Alcohol and/or Drug Prevention Event TD 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04H0025 Alcohol and/or Drug Prevention Event HN 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04H0025 Alcohol and/or Drug Prevention Event U5 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04H0025 Alcohol and/or Drug Prevention Event U6 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04H0025 Alcohol and/or Drug Prevention Event U7 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04H0025 Alcohol and/or Drug Prevention Event UC 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04H0025 Alcohol and/or Drug Prevention Event HM 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04 43.04H0031 Mental Health Assessment Event AF 220.40 245.44 214.32 168.40 256.40 174.12 134.72 255.60 203.24 240.04 223.64 227.44 181.60 207.08H0031 Mental Health Assessment Event AM 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80H0031 Mental Health Assessment Event U3 129.88 121.16 105.57 94.00 126.29 92.12 91.92 125.90 100.11 124.04 129.84 112.03 99.32 116.80H0031 Mental Health Assessment Event SA 124.36 160.04 144.00 151.20 140.00 129.40 84.00 191.72 134.00 170.00 127.48 135.16 98.92 136.00H0031 Mental Health Assessment Event AH 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80H0031 Mental Health Assessment Event AJ 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80H0031 Mental Health Assessment Event U8 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80H0031 Mental Health Assessment Event HO 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80H0031 Mental Health Assessment Event U4 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80H0031 Mental Health Assessment Event U1 124.36 160.04 144.00 151.20 140.00 129.40 84.00 191.72 134.00 170.00 127.48 135.16 98.92 136.00H0031 Mental Health Assessment Event U2 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80H0031 Mental Health Assessment Event TD 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80H0031 Mental Health Assessment Event HN 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80H0031 Mental Health Assessment Event U5 113.64 106.00 81.40 82.24 108.68 80.60 80.44 94.00 78.08 108.52 113.60 94.52 86.92 102.20H0031 Mental Health Assessment Event U6 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80H0032 Mental Health Service Plan Development by non-Physician Event AF 220.40 245.44 214.32 168.40 256.40 174.12 134.72 255.60 203.24 240.04 223.64 227.44 181.60 207.08H0032 Mental Health Service Plan Development by non-Physician Event AM 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80H0032 Mental Health Service Plan Development by non-Physician Event U3 129.88 121.16 105.57 94.00 126.29 92.12 91.92 125.90 100.11 124.04 129.84 112.03 99.32 116.80H0032 Mental Health Service Plan Development by non-Physician Event SA 124.36 160.04 144.00 151.20 140.00 129.40 84.00 191.72 134.00 170.00 127.48 135.16 98.92 136.00H0032 Mental Health Service Plan Development by non-Physician Event AH 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80H0032 Mental Health Service Plan Development by non-Physician Event AJ 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80H0032 Mental Health Service Plan Development by non-Physician Event U8 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80
Modifier 1 AF AM U3 SA AH AJ U8 U8 HO HO HO HO HO U4 U4 U4 U4 U4 U4 U1 U2Practitioner PSYTRST MD/DO PSY RES APRN PSYGST LCSW LPP LPA LPCC LMFT LPAT LBA LCADC CSW LPCA MFTA LPATA LABA LCADCA PA Psy RNModifier 1 TD HN U5 U6 U7 UC UD U9
Practitioner RN PE MHA CADC PSS CSAPreg. Wom PERDIM
CMHC Mental Health Substance Abuse Fee Schedule (Rev. 6/1/16)
Procedure Code U
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Procedure Code DescriptionH0032 Mental Health Service Plan Development by non-Physician Event HO 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80H0032 Mental Health Service Plan Development by non-Physician Event U4 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80H0032 Mental Health Service Plan Development by non-Physician Event U1 124.36 160.04 144.00 151.20 140.00 129.40 84.00 191.72 134.00 170.00 127.48 135.16 98.92 136.00H0032 Mental Health Service Plan Development by non-Physician Event U2 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80H0032 Mental Health Service Plan Development by non-Physician Event TD 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80H0032 Mental Health Service Plan Development by non-Physician Event HN 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80H0032 Mental Health Service Plan Development by non-Physician Event U5 113.64 106.00 81.40 82.24 108.68 80.60 80.44 94.00 78.08 108.52 113.60 94.52 86.92 102.20H0032 Mental Health Service Plan Development by non-Physician Event U6 88.16 98.18 85.73 67.36 102.56 69.65 53.89 102.24 81.30 96.02 89.46 90.98 72.64 82.83H0035 Partial Hospitalization under 24H Per Diem U9 194.10 194.10 194.10 194.10 194.10 194.10 194.10 194.10 194.10 194.10 194.10 194.10 194.10 194.10H0038 Self Help/Peer Svcs per 15M 15 Min. U7 8.61 8.61 8.61 8.61 8.61 8.61 8.61 8.61 8.61 8.61 8.61 8.61 8.61 8.61H0040 Assert Comm TX Pgm - 4 Prof Team Monthly U9 750.00 750.00 750.00 750.00 750.00 750.00 750.00 750.00 750.00 750.00 750.00 750.00 750.00 750.00
Modifier 1 AF AM U3 SA AH AJ U8 U8 HO HO HO HO HO U4 U4 U4 U4 U4 U4 U1 U2Practitioner PSYTRST MD/DO PSY RES APRN PSYGST LCSW LPP LPA LPCC LMFT LPAT LBA LCADC CSW LPCA MFTA LPATA LABA LCADCA PA Psy RNModifier 1 TD HN U5 U6 U7 UC UD U9
Practitioner RN PE MHA CADC PSS CSAPreg. Wom PERDIM
CMHC Mental Health Substance Abuse Fee Schedule (Rev. 6/1/16)
Modifier 1 AF AM U3 SA AH AJ U8 U8 HO HO HO HO HO U4 U4 U4 U4 U4 U4 U1 U2Practitioner PSYTRST MD/DO PSY RES APRN PSYGST LCSW LPP LPA LPCC LMFT LPAT LBA LCADC CSW LPCA MFTA LPATA LABA LCADCA PA Psy RNModifier 1 TD HN U5 U6 U7 UC UD U9
Practitioner RN PE MHA CADC PSS CSAPreg. Wom PERDIM
CMHC Mental Health Substance Abuse Fee Schedule (Rev. 6/1/16)
Procedure Code U
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Procedure Code DescriptionH2021 Community Wrap-Around Svc 15 Min. TD 32.47 30.29 23.26 23.50 31.05 23.03 22.98 26.86 22.31 31.01 32.46 27.01 24.83 29.20H2021 Community Wrap-Around Svc 15 Min. HN 32.47 30.29 23.26 23.50 31.05 23.03 22.98 26.86 22.31 31.01 32.46 27.01 24.83 29.20H2021 Community Wrap-Around Svc 15 Min. U5 28.41 26.50 20.35 20.56 27.17 20.15 20.11 23.50 19.52 27.13 28.40 23.63 21.73 25.55H2021 Community Wrap-Around Svc 15 Min. U6 22.04 24.54 21.43 16.84 25.64 17.41 13.47 25.56 20.32 24.00 22.36 22.74 18.16 20.71H2021 Community Wrap-Around Svc 15 Min. UC 28.41 26.50 20.35 20.56 27.17 20.15 20.11 23.50 19.52 27.13 28.40 23.63 21.73 25.55H2015 Comprehensive Community Support Services 15 Min. AH 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66H2015 Comprehensive Community Support Services 15 Min. AJ 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66H2015 Comprehensive Community Support Services 15 Min. U8 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66H2015 Comprehensive Community Support Services 15 Min. HO 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66 14.66H2015 Comprehensive Community Support Services 15 Min. U4 12.83 12.83 12.83 12.83 12.83 12.83 12.83 12.83 12.83 12.83 12.83 12.83 12.83 12.83H2015 Comprehensive Community Support Services 15 Min. HN 12.83 12.83 12.83 12.83 12.83 12.83 12.83 12.83 12.83 12.83 12.83 12.83 12.83 12.83H2027 Psychoeducational Service 15 Min. AH 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68H2027 Psychoeducational Service 15 Min. AJ 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68H2027 Psychoeducational Service 15 Min. U8 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68H2027 Psychoeducational Service 15 Min. HO 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68 12.68H2027 Psychoeducational Service 15 Min. U4 11.09 11.09 11.09 11.09 11.09 11.09 11.09 11.09 11.09 11.09 11.09 11.09 11.09 11.09H2027 Psychoeducational Service 15 Min. HN 11.09 11.09 11.09 11.09 11.09 11.09 11.09 11.09 11.09 11.09 11.09 11.09 11.09 11.09S9480 Intensive outpatient psychiatric services, per diem Per Diem U9 125.00 125.00 125.00 125.00 125.00 125.00 125.00 125.00 125.00 125.00 125.00 125.00 125.00 125.00S9484 Crisis Intervention (mobile crisis) per Hour 1 hour AF 220.40 245.44 214.32 168.40 256.40 174.12 134.72 255.60 203.24 240.04 223.64 227.44 181.60 207.08S9484 Crisis Intervention (mobile crisis) per Hour 1 hour AM 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80S9484 Crisis Intervention (mobile crisis) per Hour 1 hour U3 129.88 121.16 105.57 94.00 126.29 92.12 91.92 125.90 100.11 124.04 129.84 112.03 99.32 116.80S9484 Crisis Intervention (mobile crisis) per Hour 1 hour SA 124.36 160.04 144.00 151.20 140.00 129.40 84.00 191.72 134.00 170.00 127.48 135.16 98.92 136.00S9484 Crisis Intervention (mobile crisis) per Hour 1 hour AH 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80S9484 Crisis Intervention (mobile crisis) per Hour 1 hour AJ 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80S9484 Crisis Intervention (mobile crisis) per Hour 1 hour U8 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80S9484 Crisis Intervention (mobile crisis) per Hour 1 hour HO 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80S9484 Crisis Intervention (mobile crisis) per Hour 1 hour U4 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80S9484 Crisis Intervention (mobile crisis) per Hour 1 hour U2 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80S9484 Crisis Intervention (mobile crisis) per Hour 1 hour TD 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80S9484 Crisis Intervention (mobile crisis) per Hour 1 hour HN 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80S9484 Crisis Intervention (mobile crisis) per Hour 1 hour U5 113.64 106.00 81.40 82.24 108.68 80.60 80.44 94.00 78.08 108.52 113.60 94.52 86.92 102.20S9484 Crisis Intervention (mobile crisis) per Hour 1 hour U6 88.16 98.18 85.73 67.36 102.56 69.65 53.89 102.24 81.30 96.02 89.46 90.98 72.64 82.83S9485 Crisis Intervention (CSU), per diem Per Diem U9 230.00 230.00 230.00 230.00 230.00 230.00 230.00 230.00 230.00 230.00 230.00 230.00 230.00 230.00T1007 Service Planning for Substance Abuse Services Event AF 220.40 245.44 214.32 168.40 256.40 174.12 134.72 255.60 203.24 240.04 223.64 227.44 181.60 207.08T1007 Service Planning for Substance Abuse Services Event AM 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80T1007 Service Planning for Substance Abuse Services Event U3 129.88 121.16 105.57 94.00 126.29 92.12 91.92 125.90 100.11 124.04 129.84 112.03 99.32 116.80T1007 Service Planning for Substance Abuse Services Event SA 124.36 160.04 144.00 151.20 140.00 129.40 84.00 191.72 134.00 170.00 127.48 135.16 98.92 136.00T1007 Service Planning for Substance Abuse Services Event AH 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80T1007 Service Planning for Substance Abuse Services Event AJ 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80T1007 Service Planning for Substance Abuse Services Event U8 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80
Modifier 1 AF AM U3 SA AH AJ U8 U8 HO HO HO HO HO U4 U4 U4 U4 U4 U4 U1 U2Practitioner PSYTRST MD/DO PSY RES APRN PSYGST LCSW LPP LPA LPCC LMFT LPAT LBA LCADC CSW LPCA MFTA LPATA LABA LCADCA PA Psy RNModifier 1 TD HN U5 U6 U7 UC UD U9
Practitioner RN PE MHA CADC PSS CSAPreg. Wom PERDIM
CMHC Mental Health Substance Abuse Fee Schedule (Rev. 6/1/16)
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Procedure Code DescriptionT1007 Service Planning for Substance Abuse Services Event HO 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80T1007 Service Planning for Substance Abuse Services Event U4 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80T1007 Service Planning for Substance Abuse Services Event U1 124.36 160.04 144.00 151.20 140.00 129.40 84.00 191.72 134.00 170.00 127.48 135.16 98.92 136.00T1007 Service Planning for Substance Abuse Services Event U2 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80T1007 Service Planning for Substance Abuse Services Event TD 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80T1007 Service Planning for Substance Abuse Services Event HN 129.88 121.16 93.04 94.00 124.20 92.12 91.92 107.44 89.24 124.04 129.84 108.04 99.32 116.80T1007 Service Planning for Substance Abuse Services Event U5 113.64 106.00 81.40 82.24 108.68 80.60 80.44 94.00 78.08 108.52 113.60 94.52 86.92 102.20T1007 Service Planning for Substance Abuse Services Event U6 88.16 98.18 85.73 67.36 102.56 69.65 53.89 102.24 81.30 96.02 89.46 90.98 72.64 82.83