Basic Outpatient Services

Issued:  July 15, 2019

Partners to No Longer Manage Basic Outpatient Services

Effective July 10, 2019, Partners will no longer manage any Basic Outpatient Services. Partners’ network providers no longer need to submit a Service Authorization Request (SAR) for Basic Outpatient Services after 26 visits. Partners will continue to monitor utilization trends of Basic Outpatient Services through a post-payment review process. For additional questions related to Basic Outpatient Services, please contact the Utilization Management workgroup number at 704-842-6436.

General examples of Basic Outpatient Services that will no longer be managed by Partners, include, but are not limited to:

  • Individual therapy
  • Family Therapy
  • Group Therapy
  • Psychological Assessment
  • Behavioral Counseling
  • Brief Psychotherapy

Below is a list of Basic Outpatient codes that will no longer require authorization after 26 visits.

New Unmanaged Outpatient Basic Codes
Code Modifier 1 Modifier 2 Modifier 3 Description
90791 BT     90791 BT – Psychiatric Diagnostic Evaluation (No Medical Services)
90791 DJ     90791DJ – Psychiatric Diagnostic Evaluation
90791 GT     90791GT – Psychiatric Diagnostic Evaluation (No Medical Services)
90791 SC     Psychiatric Diagnostic Evaluation (No Medical Services)
90791     90791 DD – Enhanced CCA Co-Occurring D/O
90792 GT     90792GT – Psychiatric Diagnostic Evaluation with Medical Services
90792 SC     90792SC – Psychiatric Diagnostic Evaluation with Medical Services
90792     90792 – Psychiatric Diagnostic Evaluation with Medical Services
90832     90832 – Psychotherapy – 30 minutes
90832 AH 90832AH – Psychotherapy – 30 minutes
90832 BT 90832 BT – Psychotherapy – 30 minutes Brief
90832 TU 90832TU – TFU – Psychotherapy – 30 minutes
90833 90833 Psychotherapy 30 minute Add on to E&M
90833 GT 90833 GT – Psychotherapy 30 minute Add on to E&M
90834 BT 90834 BT – Psychotherapy – 45 minutes Brief
90834 TU 90834TU – TFU – Psychotherapy – 45 minutes
90836 90836 – Psychotherapy – 45 minute Add on to E&M
90836 GT 90836 GT – Psychotherapy – 45 minutes Add on to E&M Telemedicine
90837 90837 – Psychotherapy – 60 minutes
90837 BT 90837 BT – Psychotherapy – 60 minutes Brief
90837 FN 90837 FN – Psychotherapy 60 minutes Family Net
90837 GT 90837GT – Psychotherapy – 60 minutes
90837 SR 90837SR – Psychotherapy 60 minutes
90837 SR FN 90837 SRFN – Psychotherapy 60 minutes In-Home Family Net
90837 Z1 90837 Z1 – Psychotherapy Trauma Focused 60 minutes
90845 90845 – Psychoanalysis
90846 90846 – Family Therapy without Patient
90846 FN 90846 FN – Family Therapy without Patient – Family Net
90846 SR 90846 SR – Family Therapy without Patient
90846 Z1 90846Z1 – Family Therapy without Patient
90847 90847 – Family Therapy with Patient
90847 FN 90847 FN – Family Therapy with Patient Family Net
90847 SR 90847 SR – Family Therapy with Patient
90847 Z1 90847Z1 – Family Therapy with Patient
90849 90849 – Multi-Fam Group
90853 90853 – Non-Family Multi Group Therapy
96110 96110 – Developmental Test Limit
96116 96116 – Neurobehavioral Exam
96121 96121 – Neurobehavioral Exam Add 1 hour
96125 96125 – Standardized Cognitive Performance Testing (i.e., Ross Information Processing Assessment) per hour of a qualified health care professional’s time, both face-to-face time administering tests to the patient and time interpreting these test result
96130 96130 – Psychological Evaluation and Interpretation
96131 96131 – Psychological Evaluation and Interpretation Add 1 hour
96132 96132 – Neuropsychological Eval & Interpretation
96133 96133 – Neuropsychological Eval & Interpretation Add 1 hour
96136 96136 – Psychological Scoring Physician
96137 96137 – Psychological SC Physician Add 30
96138 96138 – Psychological Scoring Technician
96139 96139 – Psychological Scoring Technician Add 30
96146 96146 – Psych or Neuro Test Administered by Electronic Platform
T2013 GT T1023GT – Telemedicine Diagnostic Assessment
T2013 T1023 – Diagnostic Assessment (MH/SA)
YP830 YP830 – Alcohol and/or Drug Assessment
YP831 YP831 – Behavioral Health Counseling
YP832 YP832 – BH Group
YP833 YP833 – Behavioral Health Family Therapy W/ Client
YP834 YP834 – Behavioral Health Family Therapy W/O Client
YP835 YP835 – Alcohol and Drug Group Counseling