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Diagnostic Assessments (DA):

  1. Units Available:
    • 4 per Calendar Year
  2. Unit Length:
    • 1 Session
  3. Codes and Modifiers:
    • 90791
  4. Addon Code:
    • 90785-Interactive Complexity
  5. Location of Assessment:
    • In Person (office, client’s home, or community)
    • Telehealth that includes video and audio
  6. Performed by:
    • MH Professional
    • Clinical Trainee – Requires MH Professional’s Review and Approval

Purpose:

To assess a client for diagnosable mental health disorders, to determine a client’s eligibility for mental health services, and document the medical necessity of those services.

Functional Assessment (FA):

  1. Units Available:
    • 6 per calendar year
    • Prior authorization required for more units
  2. Unit Length: 1 Session
  3. Code Modifiers:
    • H0031
    • H0031 TS – FA Follow Up
  4. Addon Codes: None
  5. Location of Assessment:
    • In Person (office, client’s home, or community)
    • Telehealth that includes video and audio
    • Telehealth that includes audio only
  6. Performed by:
    • MH Professional
    • Clinical Trainee – Requires MH Professional’s Review and Approval
    • MH Practitioner – Requires MH Professional’s Review and Approval
    • CPS2 – Requires MH Professional’s Review and Approval

Purpose:
To assess and document a client’s mental health impairments in 13 identified domains, which can then be targeted in the client’s ITP.

H0032 Individual Treatment Plan (ITP):

  1. Units Available:
    • 4 per calendar year
    • Prior authorization required for more units
  2. Unit Length: 1 Session
  3. Code Modifiers:
    • H0032 TS – ITP Follow Up
  4. Addon Codes: None
  5. Location of Assessment:
    • In Person (office, client’s home, or community)
    • Telehealth that includes video and audio
    • Telehealth that includes audio only
  6. Performed by:
    • MH Professional
    • Clinical Trainee – Requires MH Professional’s Review and Approval
    • MH Practitioner – Requires MH Professional’s Review and Approval
    • CPS2 – Requires MH Professional’s Review and Approval

Purpose:
To assess and document a client’s rehab goals and objectives to address the impaired domains identified in the FA.

Basic Living and Social Skills (BLSS):

  1. Units Available:
    • 1200 units per calendar year (300 hours, which averages 5.75h per week)
    • Prior authorization required for more units per calendar year
  2. Unit Length:
    • 15 minutes (rounded to the nearest 15m)
  3. Codes and Modifiers:
    • H2017
    • H2017 HM – Performed by MH Rehab Worker
    • H2017 HQ – Performed in group setting
  4. Addon Codes: None
  5. Location of Assessment:
    • In Person (office, client’s home, or community)
    • Telehealth that includes video and audio
    • Telehealth that includes audio only
  6. Performed by:
    • Mental Health Professional
    • Clinical Trainee
    • MH Practitioner
    • MH Rehab Worker
    • CPS2
    • CSP1

Purpose:
****

BLSS Transition to Community Living (TCL):

  1. Units Available:
    • No Threshold, all units requires prior authorization
    • Can not be done concurrently with other ARMHS
  2. Unit Length:
    • 15 minutes (rounded to the nearest 15m)
  3. Codes and Modifiers:
    • H2017 U3
    • H2017 U3 HM – Performed by MH Rehab Worker
  4. Addon Codes: None
  5. Location of Assessment:
    • In Person (office, client’s home, or community)
    • Telehealth that includes video and audio
    • Telehealth that includes audio only
  6. Performed by:
    • Mental Health Professional
    • Clinical Trainee
    • MH Practitioner
    • MH Rehab Worker
    • CPS2
    • CSP1

Purpose:
****

Certified Peer Specialist Services (CPSS):

  1. Units Available:
    • 1200 units per calendar year (300 hours, which averages 5.75h per week)
    • Prior authorization required for more units per calendar year
  2. Unit Length:
    • 15 minutes (rounded to the nearest 15m)
  3. Codes and Modifiers:
    • H0038 – Performed by CPS1
    • H0038 U5 – Performed by CPS2
    • H0038 HQ – Performed in group setting
  4. Addon Codes: None
  5. Location of Assessment:
    • In Person (office, client’s home, or community)
    • Telehealth that includes video and audio
    • Telehealth that includes audio only
  6. Performed by:
    • CPS2
    • CSP1

Purpose:
****

Community Intervention (CI):

  1. Units Available:
    • 10 sessions per month
    • 72 Sessions per calendar year
    • Authorization required for more units per calendar year
  2. Unit Length:
    • 1 Session
  3. Codes and Modifiers:
    • 90882
    • 90882 HM – Performed by MH Rehab Worker
  4. Addon Codes: None
  5. Location of Assessment:
    • In Person (office, client’s home, or community)
    • Telehealth that includes video and audio
    • Telehealth that includes audio only
  6. Performed by:
    • Mental Health Professional
    • Clinical Trainee
    • MH Practitioner
    • MH Rehab Worker
    • CPS2
    • CSP1

Purpose:
****

CI Transition to Community Living (CITCL):

  1. Units Available:
    • No threshold, all units requires prior authorization
    • Can not be done concurrently with other ARMHS
  2. Unit Length:
    • 1 Session
  3. Codes and Modifiers:
    • 90882 U3
    • 90882 U3 HM – Performed by MH Rehab Worker
  4. Addon Codes: None
  5. Location of Assessment:
    • In Person (office, client’s home, or community)
    • Telehealth that includes video and audio
    • Telehealth that includes audio only
  6. Performed by:
    • Mental Health Professional
    • Clinical Trainee
    • MH Practitioner
    • MH Rehab Worker
    • CPS2
    • CSP1

Purpose:
****

Medication Education (Med Ed):

  1. Units Available:
    • 26 units per calendar year
    • Prior Authorization required for more units
  2. Unit Length:
    • 15 minutes
  3. Codes and Modifiers:
    • H0034
    • H0034 – Performed in group setting
  4. Addon Codes: None
  5. Location of Assessment:
    • In Person (office, client’s home, or community)
    • Telehealth that includes video and audio
    • Telehealth that includes audio only
  6. Performed by:
    • Medication Education Specialist
      • MD
      • PA
      • Pharmacist
      • RN – Under Supervision of a Medical Professional

Purpose:
****

H0046 Travel Time:

  1. Units Available:
    • 26 units per calendar year
    • Prior Authorization required for more units
  2. Unit Length:
    • 15 minutes
  3. Codes and Modifiers:
    • H0034
    • H0034 – Performed in group setting
  4. Addon Codes: None
  5. Location of Assessment:
    • In Person (office, client’s home, or community)
    • Telehealth that includes video and audio
    • Telehealth that includes audio only
  6. Performed by:
    • Medication Education Specialist
      • MD
      • PA
      • Pharmacist
      • RN – Under Supervision of a Medical Professional

Purpose:
****