Published Aug. 19, 2021
Updated Nov. 29, 2021
Partners Utilization Management (UM) has developed a Cardinal/Partners Service Code Crosswalk to assist providers with the seamless transition of services to members from Cabarrus, Stanly and Union counties. We encourage providers to use this Crosswalk as a resource when requesting Service Authorization Requests (SAR) and/or submitting claims to Partners beginning September 1, 2021.
The first two columns identify the current Cardinal Innovations Service Codes with corresponding Service Descriptions. The last three columns show the crosswalk to Partners Service Codes, Service Descriptions and Authorization Requirements. Example: Cardinal’s Specialty Therapy – 60 minutes, provider will need to submit a SAR to UM using Partners code of 90837 ZI. This service requires prior authorization.
If you have questions, please contact the appropriate Partners Utilization Management workgroup:
MHSU Utilization Management Workgroup: 704-842-6436
I/DD Utilization Management Workgroup: 704-884-2605
Inpatient Utilization Management Workgroup: 704-842-6434
Cardinal/Partners Service Code Crosswalk
| MEDICAID B SERVICES | ||||
| Cardinal Code | Service Description | Partners Code | Service Description | Partners Prior Authorization Required? |
| 250 All | Outpatient Treatment-Family Therapy | 90846-90847 FN SR | Family Therapy Codes | No |
| 251 All | Outpatient Treatment-Group Therapy | 90849; 90853 | Group Therapy Codes | No |
| 252 All | Outpatient Treatment-Individual Therapy | 90832-90834 TU, AH, GT;
90837 SR, GT, FN, SR FN;
90845
+90839- Psychotherapy Crisis 30-74 minutes
+90840 – Psychotherapy Crisis 74-minute add-on code for an additional crisis intervention
90833 GT; 90836 and 90838 allow add-on codes when EM code occurs simultaneously. |
Outpatient Individual Therapy
|
No |
| 2100 All | Community Support Team (MH/SA) (CST) | Choose “CST ALL” when requesting authorization for:
H2015 HT U1 – CST Peer Support Specialist
H2015 HT HM – CST Paraprofessional
H2015 HT HN – CST Qualified Professional/Associate Professional
H2015 HT HF – CST Substance Use Counselor (LCAS, LCAS-A, CCS, CSAC) * specific per service definition
H2015 HT HO – CST Licensed Team Lead |
Community Support Team (CST) | Yes |
| 2144 All | Peer Support Services | H0038 – Peer Supports Individual
H0038 HK – Peer Supports Individual Timely Follow-Up
H0038 DJ – Peer Supports Individual (DOJ)
H0038 HQ – Peer Supports Group
H0038 HQ DJ – Peer Support Group (DOJ)
H0038 EN – Peer Support Encounter |
Peer Support Services
|
No
|
| 90791 22 | Psychiatric Diagnostic Evaluation; Specialty Child | 90791 TI | Comprehensive Assessment Trauma Focused | Yes |
| 90791 22 GT CR | Psychiatric Diagnostic Evaluation; Specialty Child | 90791 TI CR | Comprehensive Assessment Trauma Focused | Yes |
| 90791 26 | Home Based Psychiatric Diagnostic Evaluation (Non-Medical) | 90791 IH | Home Based Psychiatric Diagnostic Evaluation (Non-Medical) | No |
| 90832 26 | Home Based Psychotherapy, 30 Minutes | 90832 IH | Home Based Psychotherapy, 30 Minutes | No |
| 90832 Q6 | Therapy 30min | 90832 | Individual Therapy 30 min | No |
| 90834 26 | Home Based Psychotherapy, 45 Minutes | 90834 IH | Home Based Psychotherapy, 45 Minutes | No |
| 90834 Q6 | Therapy 45min | 90834 | Psychotherapy 45 min | No |
| 90837 22 | Specialty therapy, 60 Minutes | 90837 Z1 | Psychotherapy Trauma Focused, 60 Minutes | Yes |
| 90837 Q6 | Therapy 60 min | 90837 | Psychotherapy – 60 Minutes | No |
| 90837 26 | Home Based Psychotherapy, 60 Minutes | 90837 SR | Psychotherapy 60 minutes | No |
| 90839 Q6 | Crisis Therapy 60min | 90839 | Psychotherapy for Crisis (30-74 Minutes) | No |
| 90846 22 | Family Therapy w/o Patient, Specialty Child Services | 90846 Z1 | Family Therapy Without Patient | Yes |
| 90846 22 GT CR | Sp Family Tx | 90846 GT CR Z1 | Family Therapy Without Patient | Yes |
| 90847 22 | Family Therapy w Patient, Specialty Child Services | 90847 Z1 | Family Therapy with Patient | Yes |
| 90847 22 GT CR
|
Sp Family Tx | 90847 GT CR Z1 | Family Therapy with Patient | Yes |
| 97153 96 | Adaptive Behavior Treatment, 1 on 1 by Tech | 97153 | RB-BHT ABA | Yes |
| 97153 96 GT | Autism Abt Individual | 97153 GT | RB-BHT ABA | Yes |
| -2161 All | Autism Abt Individual | 97153 or
97153 GT as appropriate |
RB-BHT ABA | Yes |
| 97154 96 | Group Adaptive Behavior Treatment, 1 on 1 by Tech | 97154 | RB-BHT ABA Group 2+ | Yes |
| -2162 All | Autism Abt Group | 97154 or
97154 GT as appropriate |
RB-BHT ABA Group 2+ | Yes |
| H2011 HF | Mobile Crisis Management (MH/SA) | H2011 | Mobile Crisis Management (MH/SA) | No |
| H0020 | Outpatient Opioid Treatment (Per Diem) | Providers may choose to bill per diem or weekly rate.
H0020 – Per Diem OR H0020 U3 OU – Weekly |
Outpatient Opioid Treatment | H0020 -No
H0020 U3 OU – No |
| H2021 U1 U5 (Weekly)
H2021 U5 U2 (Encounter) |
Hi Fidelity Wrap Around Weekly Billing
Hi Fidelity Wrap Around Encounter |
H0032 HF Bundled Service
H0032 HF FW Utilized as transition while in residential placement |
High Fidelity Wrap Around (HFWA) | Yes |
| H2021 U5 U2 | Outpatient Treatment-Home Based | 90837 U5
90837 U5 EN (LIP Encounter) H0036 U5 EN (QP Encounter) |
Outpatient Plus | Yes |
| H0036 HK | Intercept | H0036 U3 IC (Initial)
H0036 EN (Encounter) |
Intercept | Yes |
| H0036 HK U5 | Family Centered Treatment (FCT) | H2022 22 HE – FCT CORE
H2022 22 Z3 – FCT Encounter H2022 22 Z1 – FCT 3 Month Outcome H2022 22 Z2 – FCT 6 Month Outcome |
Family Centered Treatment (FCT) | Yes |
| H0040 TS | ACTT Encounter | H0040 EN
Choose “ACTT ALL” when requesting authorization for:
H0040 – ASSERTIVE COMMUNITY TREATMENT TEAM H0040 OT – ASSERTIVE COMMUNITY TREATMENT TEAM H0040 DJ GT CR – ASSERTIVE COMMUNITY TREATMENT TEAM Telehealth Crisis Response H0040 DJ CR – -ASSERTIVE COMMUNITY TREATMENT TEAM Telehealth Crisis Response H0040 EN GT CR – ASSERTIVE COMMUNITY TREATMENT TEAM Telehealth Crisis Response H0040 EN CR – ASSERTIVE COMMUNITY TREATMENT TEAM Telehealth Crisis Response H0040 EN DJ GT CR – ASSERTIVE COMMUNITY TREATMENT TEAM Telehealth Crisis Response H0040 EN DJ CR – ASSERTIVE COMMUNITY TREATMENT TEAM Telehealth Crisis Response H0040 GT CR – ASSERTIVE COMMUNITY TREATMENT TEAM Telehealth Crisis Response H0040 CR – ASSERTIVE COMMUNITY TREATMENT TEAM Telehealth Crisis Response H0040 EN DJ – ACTT Assertive Community Treatment Team H0040 EN – ACTT Assertive Community Treatment Team H0040 DJ – ACTT Assertive Comm Treatment Team |
ACTT Encounter | Yes |
| S5145 HI | Residential level II Family Type MH/IDD | S5145 DD | Residential level II Family Type MH/IDD | Yes |
| Y2343 | Criterion 5 for Inpatient Stay | 0902 | Criterion 5 for Inpatient Stay | Yes |
| B3 SERVICES | ||||
| Cardinal Code | Service Description | Partners Code | Service Description | Partners Prior Authorization Required? |
| H0038 HK U4 | Peer Bridger | H0038 HK BD | Post Discharge Peer Bridger/Assertive Engagement | No |
| H2011 U4 | B3 DI Services-Crisis Intervention | H2011 U4 HI | (B3) DI IDD – Crisis Services – Primary Response | Yes |
| H2016 HI U2 U4 | AFL L4 | H2016 HI U4 U2 | (B3) Level 4 AFL-Residential Supports | Yes |
| H2016 U2 U4 | AFL L1 | H2016 U4 U2 | (B3) Level 1 AFL Residential Supports | Yes |
| H2023 HE U4 | B3 Initial Individual Supported Employment | H2023 U4 HE
H2023 U4 HE DJ (TCLI member) |
(B3) Supported Employment MHSA Initial | Yes |
| H2023 HQ | Initial Group Supported Employment | H2023 HQ U4 | (B3) Initial Group Supported Employment | Yes |
| H0045 U4 | B3 Individual Respite | H0045 U4 HA
H0045 U4 HB |
(B3) Child Respite Individual
(B3) Adult Respite Individual |
Yes |
| H0045 HQ U4 | B3 Group Respite | H0045 HQ U4 HA
H0045 HQ U4 HB |
(B3) Child Respite Group
(B3) Adult Respite Group |
Yes |
| T2014 U2 U4 | B3 DI Services-Residential Supports Level 2-AFL | T2014 U4 U2 | (B3) DI Level 2 AFL – Residential Supports | Yes |
| T2020 U2 U4 | B3 DI Services-Residential Supports Level 3-AFL | T2020 U4 U2 | (B3) DI Level 3 AFL – Residential Supports | Yes |
| T2041 U4 UA | B3 Community Guide (AWC Members) | T2041 U4 | (B3) DI Community Navigator-Monthly | Yes |
| T2041 U6 U4
T2041 UC U4
|
Community Guide Annual Information Session on Self-Direction
Community Guide Annual Information Session on Self-Determination and Rights |
T2041 U4 YI | (B3) Community Navigator Annual Information Session | Yes |
| T2041 U6 U4 UA
T2041 UC U4 UA |
Community Guide Annual Information Session on Self-Direction (AWC Members)
Community Guide Annual Information Session on Self-Determination and Rights (AWC) |
T2041 U4 YI EO | (B3) DI Community Guide Annual Information Session | Yes |
| INNOVATIONS SERVICES | ||||
| Cardinal Code | Service Description | Partners Code | Service Description | Partners Prior Authorization Required? |
| H2011 | Innovations Crisis Response | H2011 HI | Innovations Crisis Response | Yes |
| T2025 GT | Special Consultation Services | T2025 GT CR | Special Consultation Services | Yes |
| T2041 UA | Community Navigator (AWC) | T2041 | Community Navigator Monthly | Yes |
| T2041 UB | Community Navigator (EOR) | T2041 | Community Navigator | Yes |
| T2041 U1 UA | Community Navigator Start Up Training for Agency with Choice | T2041 U1 | Community Navigator Start Up Training Only | Yes |
| T2041 U1 UB | Community Navigator Start Up Training for Employer of Record | T2041 U2 | Community Navigator EOR Training Monthly | Yes |
| T2041 U6
T2041 U6 CN
T2041 U6 UA
T2041 UC
T2041 UC UA
|
Community Navigator Annual Information Session on Self-Direction
Community Navigator Annual Information Session on Self-Direction
Community Navigator Annual Information Session on Self-Direction (AWC Members)
Community Navigator Annual Information Session on Self-Determination & Rights
Community Navigator Annual Information Session on Self-Determination & Rights (AWC) |
T2041 YI
|
Community Navigator Annual Information Session | Yes |
| T2041 U6 UB
T2041 U6 CN
T2041 UC UB
|
Community Navigator Annual Information Session on Self-Direction (EOR Members)
Community Navigator Annual Information Session on Self-Direction (EOR Members)Community Navigator Annual Information Session on Self-Determination & Rights (EOR) |
T2041 YI EO | Community Navigator Annual Information Session
|
Yes |
| STATE SERVICES | ||||
| Cardinal Code | Service Description | Partners Code | Service Description | Partners Prior Authorization Required? |
| Q3014 | Telehealth Originating Site Facility Fee | Q3014 GT | Telemedicine Originating Site Fee | No |
| YA323 FC | Assertive Engagement | YA341 | Assertive Engagement | Yes |
| YA389 GT | Supported Employment LT IDD | YA389 GT CR | Long Term Vocational Support | Yes |
| YA344 | Peer Bridger | YA356 | Peer Bridger | No |
| YM120 U2 | Transition Management Services Mon | YM120 | Tenancy Support | Yes |
| YP500 | Emergency Respite | S5145RR | Rapid Response Bed
|
Yes |
| YP620 GT | ADVP Tele | YP620 GT CR | ADVP | Yes |
| YP630 GT | IPS-SE Telehealth | YP630 GT CR | Supported Employment Individual | Yes |
| YP660 GT | Day Activity Telehealth | YP660 GT CR | Day Activity | No |
| In Lieu Of Services (ILO) | ||||
| Cardinal Code | Service Description | Partners Code | Service Description | Prior Auth required? |
| H2011 U5 U1
H2011 U5 U1 TS (Encounters) |
Enhanced Crisis Response | H2011 U5 U1
H2011 U5 TS (Encounters) |
Enhanced Crisis Response (ECR) | Yes |
| H2022 HE U5
H2022 HE U5 GT CR |
In Home Therapy Services (IHTS) | H2022 HE U5 U1
H2022 HE U5 TS (Encounters)
H2022 HE U5 U1 CR
H2022 HE U5 TS CR (Encounter) |
In Home Therapy Services (IHTS) | Yes |
| H0040 TS U5 | Assertive Community Treatment- Step Down (ACT-SD) | H0040 U5 | Assertive Community Treatment- Step Down (ACT-SD) | Yes |
| S9480 U5 | Rapid Care Services Low | S9480 U5 | Rapid Care Services Low | No |
| S9480 HK U5 | Rapid Care Services High | S9480 HK U5 | Rapid Care Services High | No |
| T2016 CR | Case Support, Special Situation | T1016 U5 | Case Support, Special Situation | Yes |
| H0018 HA
H0018 HB |
Residential Services- Complex Needs | H0018 | Residential Services- Complex Needs | Yes |
| YP500 | Rapid Response Bed | S5145 U5 (Medicaid)
S5145 RR (State) |
Rapid Response Bed | Yes |
| YA402 | Case Support Disaster (State) | Please consult your Provider Network Specialist for details. | ||
| YA403 | Comprehensive Clinical Support (State) | |||