ࡱ> oqne bjbjڭڭ pYbYbWT T 4hl<C2Pp,,,1111111$4I7`1"1,,1f!f!f!,,1f!1f!f!+h.,`cDh|p.<120C2.<88x..J82/|f!11 C28T B : This section lists the CPT codes and maximum allowances for psychological services. Refer to the Psychological Services section in this manual for policy information. Reimbursement will be made at the providers usual charge to the general public, not to exceed the following maximum allowances (California Code of Regulations [CCR], Title 22, Section 51505.3). Psychotherapy The following services may be provided by a psychologist, Licensed Clinical Social Worker (LCSW), Licensed Professional Clinical Counselor (LPCC) or Marriage and Family Therapist (MFT) and are reimbursable as follows: CPT CodeDescriptionMaximum Allowance90832Psychotherapy, 30 minutes with patient$18.9890837Psychotherapy, 60 minutes with patient$38.0190839Psychotherapy for crises, first 60 minutes$38.0190840Psychotherapy for crises each additional 30 minutes$18.9890846Family psychotherapy (without the patient present), 50 minutes$86.6490847Family psychotherapy (with patient present), 50 minutes$89.6590849Multiple-family group therapy$31.8590853Group psychotherapy, (other than of a multiple-family group)$14.4899354Prolonged psychotherapy service requiring direct patient contact beyond the usual service; first hour$112.41 Associate marriage and family therapists, associate professional clinical counselors, associate clinical social workers and psychology assistants may render psychotherapy services under the direct supervision of a licensed mental health professional in accordance with applicable state laws. The claim must list the associate or assistants name in the Additional Claim Information field (Box 19) or in an attachment, along with the supervising clinicians National Provider Identifier number as the billing provider. Central Nervous System The following services may be provided by a psychologist and are Assessments/Tests reimbursable as follows: CPT CodeDescriptionMaximum Allowance96105Assessment of aphasia, per hour$51.2096110Developmental screening, per standardized instrument$54.9096112Developmental test administration, first hour$116.5796113each additional 30 minutes$51.8796116Neurobehavioral status exam, first hour$82.1096121each additional hour$70.1796130Psychological testing evaluation services; first hour$99.6096131each additional hour$75.8196132Neuropsychological testing evaluation services; first hour$113.3796133each additional hour$86.4396136Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests; first 30 minutes$41.8896137each additional 30 minutes$39.0196138Psychological or neuropsychological test administration and scoring by technician, two or more tests; first 30 minutes$35.6996139each additional 30 minutes$35.6996146Psychological or neuropsychological test administration, via electronic platform, with automated result only$1.84 Note: Pre-test interviews, pre-test instructions and test materials are not separately reimbursable. Compensation for these services has been included in the maximum rate for test administration. Medical Team Conference The following services may be provided by a psychologist, LCSW, LPCC or MFT and are reimbursable as follows: CPT CodeDescriptionMaximum Allowance99366Medical team conference, recipient and/or family present per 30 minutes,$18.9899368Medical team conference, recipient and/or family not present, per 30 minutes$18.98 End of Life Services Refer to the End of Life Option Act Services section in this manual for additional information. Supervising Clinician Associate marriage and family therapists, associate professional Billing Requirements for clinical counselors, associate clinical social workers and psychology Psychological Services assistants may render the above related psychology services under a supervising clinician. The claim must list the associate or assistants name in the Additional Claim Information field (Box 19) or on an attachment, along with the supervising clinicians National Provider Identifier number as the billing provider.     psychol cd  PAGE 2 Psychological Services: Billing Codes psychol cd and Reimbursement Rates  PAGE 1 2 Psychological Services: Billing Codes and Reimbursement Rates Allied Health Psychological Services December 2013 2 Psychological Services: Billing Codes and Reimbursement Rates Allied Health Psychological Services 537 June 2020 psychol cd  PAGE 2 psychol cd  PAGE 3 2 Psychological Services: Billing Codes and Reimbursement Rates Allied Health Psychological Services 519 December 2018 2 Psychological Services: Billing Codes and Reimbursement Rates Allied Health Psychological Services___ ________ 2018 psychol cd  PAGE 2 psychol cd  PAGE 3 2 Psychological Services: Billing Codes and Reimbursement Rates Allied Health Psychological Services 497 February 2017 2 Psychological Services: Billing Codes and Reimbursement Rates Allied Health Psychological Services 532 January 2020 d{, J p } [ m u ~  " # d e j k   " # $ n o t u  GcȬȬȬȬ hi.6^J hk^J hi.^JhQhi.5>*OJQJ hi.5>* hQhi.hQhi.5>*hi.OJQJ hi.>* hi.5 hi.6hmqhi.H*^Jhi.jhi.U:n o p X a m  Mgkd$$IflF !%G,G%Gk t6    44 lBa0 yt]B $x$Ifa$gd]B x$Ifgd]B  !$ x$If] gd]B 0 x]^0 `gdi.]gdi. i[$x$Ifa$gd]B jkdt$$IflF %F,FF( t6x    44 lBa0 yt]B $ hx$Ifa$gd]B x$Ifgd]B  x$If] gd]B   " {m$x$Ifa$gd]B x$Ifgd]B  x$If] gd]B jkd$$IflF %F,FF( t6x    44 lBa0 yt]B " # ) ] d wi$x$Ifa$gd]B  x$If^ gd]B  x$If] gd]B jkdZ$$IflF %F,FF( t6x    44 lBa0 yt]B d e k wi$x$Ifa$gd]B  x$If^ gd]B  x$If] gd]B jkd$$IflF %F,FF( t6x    44 lBa0 yt]B  zl$x$Ifa$gd]B  x$If^ gd]B  x$If] gd]B gkd@$$IflF %,( t6x    44 la0 yt]B   # zl$x$Ifa$gd]B  x$If^ gd]B  x$If] gd]B gkd$$IflF %,( t6x    44 la0 yt]B # $ * g n t $$Ifa$gd]B x$Ifgd]B  $If] gd]B gkd$$IflF %,( t6x    44 la0 yt]B n o u s $$Ifa$gd]B $Ifgd]B  $If] gd]B jkd$$IflF %F,FF( t6x    44 lBa0 yt]B  Jzmm\G !0 ]^0 `gdk !0 ]^0 gder  !]gdi. 0 ]^0 gdi.  ]gdi.gkd$$IflF %,( t6x    44 la0 yt]B J\y}~ ABIaklrt ӽⶬӘӎ⬢⶘hmMhk5>*hR-:hk5>*hghk5>*h3hk5>* hk5>* hw]hkh'<hk>* h hk hFbhkhNshk>*hk hk5ha{h3E4hOh&hQhi.^J8Ju~Fzkdg$$IflF 9%u@ tD6    44 la0 pyt:0$x$Ifa$gd:0x$If]gd:0 x$Ifgd:0 !0 x]^0 `gdk zk]$x$Ifa$gd:0x$If]gd:0 x$Ifgd:0zkd$$IflF 9%u@ tD6    44 la0 pyt:0 BJzgY$x$Ifa$gd:0 } x$If]gd:0 x$Ifgd:0zkd$$IflF 9%u@ tD6    44 la0 pyt:0JKQlszgY$x$Ifa$gd:0x$If]^gd:0 x$Ifgd:0zkd$$IflF 9%u@ tD6    44 la0 pyt:0stzzk]$x$Ifa$gd:0x$If]gd:0 x$Ifgd:0zkd$$IflF 9%u@ tD6    44 la0 pyt:0zgY$x$Ifa$gd:0x$If]^gd:0 x$Ifgd:0zkd$$IflF 9%u@ tD6    44 la0 pyt:0 |ma $$Ifa$gd:0x$If]gd:0 $Ifgd:0zkd$$IflF 9%u@ tD6    44 la0 pyt:0,3|i] $$Ifa$gd:0x$If]^gd:0 $Ifgd:0zkd,$$IflF 9%u@ tD6    44 la0 pyt:0,34:tu}~#HIPQqryz '(-.ehij no軷 hFbhThNshT>* h &hThT hT5 h9Dhk hk5 hk5>*hk5>*^JhAgGhk5>*^Jhkhghk5>*hAgGhk5>*>34:u}|i] $$Ifa$gd:0x$If]^gd:0 $Ifgd:0zkd$$IflF 9%u@ tD6    44 la0 pyt:0}~|i] $$Ifa$gd:0x$If]^gd:0 $Ifgd:0zkd> $$IflF 9%u@ tD6    44 la0 pyt:0IP|ma $$Ifa$gd:0x$If]gd:0 $Ifgd:0zkd $$IflF 9%u@ tD6    44 la0 pyt:0PQWryzgY$x$Ifa$gd:0x$If]^gd:0 x$Ifgd:0zkdP $$IflF 9%u@ tD6    44 la0 pyt:0yzxeW$x$Ifa$gd:0x$If]^gd:0 x$Ifgd:0|kd $$IflVF 9%u@ tD6    44 la0 pyt:0 'xeW$x$Ifa$gd:0x$If]^gd:0 x$Ifgd:0|kdf $$Ifl&F 9%u@ tD6    44 la0 pyt:0'(.zma $$Ifa$gd:0 $If]gd:0 $Ifgd:0|kd $$IflhF 9%u@ tD6    44 la0 pyt:0hijt_JJ5 !0 ]^0 `gdT !0 ]^0 `gdk !]^`gdk !0 ]^0 gdkzkd $$IflF 9%u@ tD6    44 la0 pyt:0gODD x$Ifgd"-wkd $$IflF x $h t,6    44 la0 pyt"-$ !$x$Ifa$gd"- !$x$Ifgd"- !0 x]^0 gdTgnouyppd $$Ifa$gd"- $Ifgd"-wkd $$IflF x $h t,6    44 la0 pyt"-$x$Ifa$gd"-BCDEzzzezzzP !0 ]^0 `gdT 0 0 ]^0 `gdT  !]gdTwkd$$IflF x $h t,6    44 la0 pyt"- *@BEZ)FGPmp TUWXZ[]^`acǽh5%jh5%Uhkh &hT^JhPhT^Jh+hT6^JhdhT^J hT^JhZhT5^JhThTCJaJhT6CJaJhMhT6CJaJhMhTCJaJhMhT5CJaJ3UVWYZ\]_`bcnz{| !$&dP]gdM. !$]gdM.  !]gdk !0 ]^0 gdT !0 ]^0 `gdTcijnouvwxz|>GLMž}vpjpd^dVhi.CJaJ hi.CJ h`OCJ hW}CJ hS>CJ h^ hS>jh^ 0J5CJU*hd<0J5CJmHnHu*h^ 0J5CJjh^ 0J5CJU h^ 5 h^ CJ h^ 5CJhS> hS>CJha{0J5CJmHnHuhS>0J5CJjhS>0J5CJU h~V5 hS>5|>LMr  !]gda{gd`O$ !$]a$gd`O !$]gd`Ogda{$ !$]a$gda{ !$]gdM.$ !]a$gd^  $&dP]gd^ $]gd^ stu ¾ਡtkttea]hNsha{ ha{CJha{0J5CJjha{0J5CJU ha{5h hkCJaJhXhkCJ hkCJ h^ hk hk5CJhk0J5CJmHnHuhk hkCJhd<0J5CJmHnHuhk0J5CJjhk0J5CJU hk5hS>h TCh`OaJ$ftuq$ !]a$gdb&  !$]$ !]a$gdX !$]gdX$ !]a$gd^  $&dP]gd^ $]gd^ ]gda{ !&dP]gda{   !q$ !]a$gdX !$]gdX$ !]a$gd^ $ $&dP]a$gdk$ $]a$gdk $]a$gdk$ !&dP]a$gdk$ !]a$gdk  ! 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