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 U2 Community Navigator EOR Training Monthly 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)