Issued:  April 30, 2020

Additional Service Flexibilities

The following codes have been added to Medicaid contracts with an effective date of March 10, 2020, with no action required by providers. These codes are in addition to those that were included in Partners Provider Alert COVID 19 #21-Behavioral Health Service Flexibilities | Place of Service, dated April 24, 2020.

Base Code

Mod 1

Mod 2

Mod 3

T1023 GT CR
T1023 CR
H0010 CR
H0014 CR
H0012 HB CR
H0013 CR
H0019 HK CR
H0019 HQ CR
H0019 TJ CR
H0019 U5 CR
H0019 UR CR
H2020 CR
H2017 CR
H2017 GT CR
H2017 DJ CR
H2017 DJ GT CR
H2012 HA GT CR
H2012 HA CR
H0035 CR
H0035 GT CR
H0015 AD GT CR
H0015 AD CR
H0015 CR
H0015 GT CR
H2035 CR
H2035 GT CR
S9484 CR
S9484 HA CR
H2036 CR
90792 GT CR
90792 CR
90836 CR
90836 GT CR
90838 CR
90838 GT CR
96110 CR
96110 GT CR
96112 CR
96112 GT CR
96113 CR
96113 GT CR
96116 CR
96116 GT CR
96121 CR
96121 GT CR
96130 CR
96130 GT CR
96131 CR
96131 GT CR
96132 CR
96132 GT CR
96133 CR
96133 GT CR
96136 CR
96136 GT CR
96137 CR
96137 GT CR
96138 CR
96138 GT CR
96139 CR
96139 GT CR
96146 CR
96146 GT CR
99421 GT CR
99422 GT CR
99423 GT CR
99446 GT CR
99447 GT CR
99448 GT CR
99449 GT CR
99421 CR
99422 CR
99423 CR
99446 CR
99447 CR
99448 CR
99449 CR
99201 GT CR
99202 GT CR
99203 GT CR
99204 GT CR
99205 GT CR
99211 GT CR
99212 GT CR
99213 GT CR
99214 GT CR
99215 GT CR
99241 GT CR
99242 GT CR
99243 GT CR
99244 GT CR
99245 GT CR
99251 GT CR
99252 GT CR
99253 GT CR
99254 GT CR
99255 GT CR

As a reminder, providers should adhere to Medicaid guidance when using modified codes as follows:

  • Modifier GT must be appended to the CPT or HCPCS code to indicate that a service has been provided via interactive audio-visual communication. This modifier is not appropriate for services performed telephonically or through email or patient portal.
  • Modifier CR (catastrophe/disaster-related) must be appended to all claims for CPT and HCPCS codes billed using the allowed flexibilities.

Partners has not automatically added to contracts any service codes with ONLY the GT modifier without also including the CR modifier. Providers who are in full compliance with all telehealth requirements with no COVID 19 flexibilities must request to have GT codes added using the Provider Change Form.

The three codes below have been end dated in provider contracts effective March 20, 2020. Although it was Partners’ intention to provide additional flexibilities using these codes, they were unable to be reimbursed at the level of service provided. Providers now have the option of using Partners In Lieu Of services or the flexibilities offered in the codes listed above. Providers should direct questions regarding these codes to your Provider Account Specialist or email the Provider Help Desk.

  • H0015 CV – Substance Abuse Intensive Outpatient 15 minutes
  • H0035 CV – Mental Health Partial Hospitalization 15 minutes
  • H2022 CV – Intensive In-Home 15 minutes

Please note that claims previously approved will be re-adjudicated to recoup. Partners Claims Department will complete this process and will contact the provider once competed. Once recouped, providers should submit claims with the new procedure code. Please direct any claims-related questions to

Outpatient Opioid Treatment (OOT) Service Authorization Requests

For Medicaid Members:

Effective June 1, 2020, Outpatient Opioid Treatment (OOT) providers may begin submitting Service Authorization Requests (SARs) for Medicaid members with the following service code:

H0020 (U3) (OU) – Weekly Rate for Outpatient Opioid Treatment
H0020U3OU is an alternative payment method utilized for Medicaid OOT. The cost of dosing visits, medication, medication dispensing and counseling will be bundled under a weekly rate. Please submit a Change Request Form to Credentialing and Enrollment if you are an Outpatient Opioid Treatment provider interested in adding this service to your contract.

The H0020 service code (no modifier) may be used for dually insured members with Medicare and Medicaid. Providers must submit claims to Medicare as primary payor before Medicaid.

OOT Retroactive SARs:

Partners Utilization Management will allow submission of OOT retroactive SARS for Medicaid members back to March 8, 2020. Retro dates may be requested from March 8, 2020 to March 18, 2020. No prior approval is needed during COVID-19 crisis effective March 19, 2020 through May 31, 2020. Providers may submit claims directly to Partners for services rendered during the COVID-19 crisis period. All retroactive SARS must be submitted to Partners Utilization Management by July 1, 20200.

Partners Outpatient Opioid Treatment Benefit Plan for Medicaid Members

Service Description Benefit Limit Level of Care Source Documentation Required for Authorization
Outpatient Opioid Treatment:


H0020 Per Diem


H0020 (U3) (OU) – Weekly


Initial: 60 days

H0020 – 60 units for 60 days

H0020U3OU – 9 units for 60 days


Concurrent: 180 days

H0020 – 180 units for 180 days

H0020U3OU – 26 units for 180 days








8A Initial:  Tx Plan. Service order is required and is due on or before the first date of service. Service Order must be signed by a MD or DO. Service Order is valid for one year.


Concurrent: Updated Tx Plan and signature page w/each request.

For State-funded Members:

Providers may continue to bill H0020U3OU for State-funded members. However, no prior approval or service authorization request is required at this time for State-funded H0020U3OU. Please consult the State-Funded Alternative Service Definition for Opioid Treatment Program Bundle for benefit limits and documentation requirements.

Prior approval is required for Office Based Opioid Treatment (OBOT) which are service codes YA396 (S1), (S2), and (S3).

OOT providers should note that the service code H0020U3BU has been discontinued for Medicaid and State-funded members.

If you have additional questions regarding service authorization requests, please contact the Mental Health/Substance Use (MHSU) UM Workgroup at 704-842-6436.

If you have additional questions regarding Credentialing and Enrollment, please contact 704-842-6483.

Partners to Host Service Informational Sessions for Members and Their Families

Do you work with members that are confused about service changes due to COVID-19? Partners is here to help. Members that receive services from Partners’ providers as well as their family members are invited to an upcoming question and answer session:

Partners Member Information Session for Intellectual/Developmental Disabilities and Traumatic Brain Injury Service Changes

Tuesday, May 5, 2020 at 4 p.m.
Click here to register for the May 5 webinar

Partners Member Information Session for Mental Health and Substance Use Service Changes

Thursday, May 7, 2020 at Noon
Click here to register for the May 7 webinar

Members and their families are welcome to email any questions to or call 704-884-2666 for more information.

Personal Protective Equipment

During the COVID-19 pandemic, there has been a shortage of Personal Protective Equipment (PPE). NC DHHS and the NC Department of Public Safety are actively working to get PPE to organizations in need. To learn more about conservation measures of existing supplies or to request additional PPE, please visit

Joint Communication Bulletins

NC DHHS has published two Joint Communication Bulletins:

Click here to view all Joint Communication Bulletins.