September 16, 2016

Effective October 1, 2016, Partners’ credentialed clinicians rostered by North Carolina Child Treatment Program (NC CTP) for Trauma Focused Cognitive Behavior Therapy (TF CBT) will be eligible to bill an enhanced rate for this service.

When a provider submits billing for these codes, they are attesting to the fact that the clinician is rostered with NC CTP.  The enhanced rate applies only to clinicians who are rostered and not to those in the training/rostering process.  If billing and payment occurs for clinicians who are not rostered, those claims will be recouped.

Providers should submit a Request for Nomination Form to add the new service code for the site from which the NC CTP-rostered clinician will be working.  New service codes and rates are as listed below:

Service  – Z1 modifier for each Current Rate New Rate
90837 Z1 – Psychotherapy – 60 Minutes $           94.74 $   125.00
90846 Z1- FAMILY THERAPY WITHOUT PATIENT $          54.17 $     84.42
90847 Z1- FAMILY THERAPY WITH PATIENT $           67.28 $     97.53

If you have questions, please contact your Account Specialist for further information.

DMA/DMH Joint Communication Bulletin #J217
Psychiatric Mental Health Nurse Practitioner Sunset Provision

DMA/DMH Joint Communication Bulletin #J217 addresses the sunset provision regarding the enrollment extension of Nurse Practitioners.

View #J217.

Visit DMA/DMH Joint Communication Bulletins to access past Joint Communication Bulletins.