CTIA Rate Update; Revision to July 15, 2019 Alert

Issued:  September 9, 2019

Updated: New Rate for Comprehensive Trauma Informed Assessments (CTIA)

Please note the updates to the list of the providers participating in the CTIA Learning Collaboratives.

Provider agencies who have been participating in the CTIA learning collaborative hosted by the Center for Child and Family Health can now request to add the code 90791 TI to their contracts.  The rate for this code is $125 per hour for up to 5 hours.

The provider agencies participating in the CTIA learning collaborative are:

  • A Caring Alternative
  • Alexander Youth Network
  • Charlotte Counseling and Consulting PLLC
  • Children’s Home of Cleveland County
  • Children’s Home Society
  • Children’s Hope Alliance
  • Support, Inc.

Please complete the Provider Change Form, located at https://providers.partnersbhm.org/provider-enrollment-credentialing/, to add this code and refer to Provider Communication Bulletin #96 for the Scope of Work regarding this code.

Revision to July 15, 2019 Provider Alert/Provider Bulletin #95: Partners to No Longer Manage Basic Outpatient Services

On July 15, 2019, Partners announced that it would no longer manage Basic Outpatient Services, and included this information in Provider Bulletin #95. On July 23, 2019 Partners issued a second alert stating that the change was effective beginning with dates of service July 1, 2019.

Four codes were included in the initial July 15 Provider Alert that will continue to be managed as specialty services. Trauma Focused Cognitive Behavioral Therapy (TF-CBT) and Eye Movement Desensitization Program (EMDR) will continue to be managed by Partners as specialty services to our members.  Prior Authorization will be required for the following codes:

TF-CBT: Initial/Concurrent Request—13 units per 90 days
90837 ZI — Trauma Focused CBT
90846 ZI — Trauma Focused CBT Family without patient
90847  ZI – Trauma Focused CBT Family with patient

EMDR:
90837 EM – Initial/Concurrent:  13 units per 90 days

The following table contains a revised list of Unmanaged Outpatient Basic Codes effective with Dates of Service July 1, 2019. If you have questions, please reach out to the Utilization Management Workgroup at 704-842-6436.

Unmanaged Outpatient Basic Codes
Code Modifier 1 Modifier 2 Modifier 3 Description
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
90837 90837 – Psychotherapy – 60 Minutes
90837 BT 90837 BT – Psychotherapy – 60 Minutes Brief
90837 EM     90837 EM – EMDR
90837 FN 90837 FN – Psychotherapy 60 Min Family Net
90837 GT 90837GT – Psychotherapy – 60 Minutes
90837 SR 90837SR -Psychotherapy 60 minutes
90837 SR FN 90837 SRFN – Psychotherapy 60 Min 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 – Devel Tst Lmt
96116 96116 – Neurobehav Exam
96121 96121 – Neurobehavioral Exam Add 1 Hr
96125 96125 – Standardized Cognitive Performance Testing (eg, 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 – Psychol 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
Additional Code

90791 –

BT Psychiatric Diagnostic Evaluation