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Colorado Access is the behavioral healthcare administrator
for members on the CHP+ State Managed Care Network.
Providers:If you would like more information or would like to become a CHP+ behavioral health provider, please call 720-744-5219 or toll free at 1-800-511-5010 extension 5219. You may also submit a request through our online Contract Request form.
Members: If you would like more information or need assistance finding a behavioral health provider in your area, please contact us at 303-751-9051 or toll free at 1-800-414-6198 if you have questions.
Behavioral Health Covered Codes for CHP+ SMCN
Notice of Material Changes to Current Procedural Terminology (CPT) Codes for Psychiatry Services
Several commonly used psychiatric CPT codes have been deleted or modified.
The changes are effective January 1, 2013.
The CPT codes are mandatory. Noncompliance is a HIPAA violation.
Several commonly used psychiatric CPT codes have been deleted and new ones have been added. Key changes include:
- Coding changes will effect 908xx series therapy codes, including the replacement of 90862, and will include allowing the 9920x and 9921x series codes for psychiatrist, advanced practice nurses, and physician assistants
- Removal of Evaluation and Management (E&M) services from the psychiatry section
- Deletion of pharmacologic management (providers to use appropriate E&M code)
- Psychotherapy and E&M services are distinguished from each other (time spent on E&M services is not counted towards psychotherapeutic services, and they have separate codes that can be used in combination with one another)
- Inclusion of add on codes for psychiatry, which are services that are performed in addition to a primary service or procedure (and never as a stand-alone service)
- Addition of code 90785 for interactive complexity
- New code for psychotherapy for a patient in crisis
The switch to the new CPT codes are based on date of service, not when the claim is submitted.
The AMA does not allow for a transition period. Providers must bill with the new CPT codes for dates of service on or after January 1, 2013 or the claim will deny.
State Managed Care Network Notices
Click here to read a copy of the entire notice.
Helpful Resources
Click here to download the Uniform Service Coding Standards Manual - 2013 CPT Code Changes DRAFT
Click here to review the Crosswalk for the 2012 to 2013 CPT code sets created by The National Council for Community Behavioral Healthcare.
Click here for the AACAP Code Selection Algorithm
Click here to download the CMS Evaluation and Management Services Guide
Click here to review the AACAP Crosswalk
Click here for the CBHC December 5th Crosswalk
Important Links
Colorado Behavioral Healthcare Council
American Academy of Child and Adolescent Psychiatry
Novitas Solutions
American Medical Association
APA Practice Central
Meetings and Webinars
An excellent comprehensive webinar was presented by the National Council for Community Behavioral Healthcare on November 9, 2012. This archived webinar can be accessed here. We encourage you to listen to this webinar. Click here for a copy of the slides.
On December 3, 2012 the National Council presented a webinar on the use of the evaluation and management codes. This archived webinar can be accessed here. Click here for a copy of the slides.
If you have questions, please contact Provider Network Services at pns@coaccess.com or contact your Provider and Community Liaison. |
