CALAIM Tus Cwj Pwm Coj Tus Cwj Pwm Kev Them Nyiaj Them Nqi Kho Mob Cov Lus Nug nquag
Kho tshiab kawg 7/14/25
Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tau ua raws li Txoj Cai Them Nqi Kho Tus Cwj Pwm (BH) Lub Xya Hli 1, 2023. Txoj kev pib hloov pauv txoj kev DHCS them rov qab cov nroog rau Cov Kev Pabcuam Kev Puas Siab Puas Hlwb Tshwj Xeeb (SMHS), Tshuaj Kho Mob Medi-Cal (DMC), thiab Tshuaj Kho Mob Medi-Cal Organized Delivery System (DMC-ODS). Kev Hloov Pauv Kev Noj Qab Haus Huv Kev Noj Qab Haus Huv suav nrog ntau qhov kev hloov pauv ntsig txog Cov Txheej Txheem Txheej Txheem Tam Sim No (CPT) coding, Kev Hloov Pauv Hloov Pauv (IGTs), hloov kho cov txheej txheem them rov qab thiab cov sij hawm them nqi tshiab.
DHCS tau tsim cov lus nug uas nquag nug (FAQs) los muab cov ncauj lus kom ntxaws ntxiv txog ntau lub ntsiab lus hais txog Kev Them Nqi Kev Noj Qab Haus Huv. Rau FAQs ntsig txog IGTs, thov saib ntawm no.
Cov Lus Qhia
Kev Pabcuam Kev Tswj Xyuas thiab Kev Siv Tshuaj Xyuas / Kev Pov Hwm Zoo (UR / QA)
Mob Psychiatric Inpatient Rates
Qhov Kev Pabcuam Kev Kho Tshuaj Ntxov (NTP) Tus Nqi
Kev Siv Tshuaj Tsis Zoo (SUD) Cov Nqi Nyob Nyob
Mobile Crisis Rates
General Rate Information
General Billing & Coding
Kev cob qhia online (Nqe ntxiv 7/14/2025)
Kawm Tiav/Student Billing
Kev pab txhais lus
Cov Kev Pab Cuam Tshuam
Cov kws saib mob uas muaj ntawv tso cai ua haujlwm (LVNs) thiab cov kws kho mob puas siab puas ntsws (LPTs) hauv Cov Kev Pabcuam Kev Mob Siab Tshwj Xeeb thiab Tshuaj Medi-Cal
Lub Sijhawm Saib Xyuas Neeg Mob Tsis Ncaj Ncees
Kev Pabcuam Ntau Pab Pawg
Hom Kev Pabcuam Tshiab
Tshaj Tawm Lub Sijhawm Tshaj Tawm Txoj Cai Tseem Ceeb rau Kev Thov nrog Hnub Ua Haujlwm tom qab Lub Rau Hli 30, 2024 (Tshooj ntxiv 6/18/2024)
Kev Ntsuam Xyuas thiab Kev Tswj Xyuas (E&M).
Tsis-E&M Kev Ntsuas Kev Ntsuas
Non-E&M Therapy Services
Lub nroog thov li cas rau Kev Pabcuam Kev Tswj Xyuas thiab Kev Tshawb Fawb Kev Siv thiab Kev Pov Hwm Zoo raws li BH Them Nyiaj Hloov Kho?
Kev thov rau cov kev pabcuam kev tswj hwm thiab UR/QA tsis hloov pauv raws li Kev Them Nyiaj Them Rov Qab thiab yuav nyob twj ywm raws li cov txheej txheem Certified Public Expenditure (CPE) tam sim no. Peb lub hlis twg thiab ib xyoos twg, cov nroog yuav xa daim ntawv thov rau kev tswj hwm thiab UR/QA cov kev pabcuam uas yuav rov sib raug zoo rau tus nqi. Txawm hais tias tus txheej txheem no yuav nyob twj ywm tus nqi sib raug zoo, DHCS tau cog lus los txhim kho qhov ua tau zoo ntawm cov txheej txheem no kom txo tau lub nra ntawm kev tswj hwm hauv nroog. DHCS tau luam tawm BHIN 23-049 Kev Tswj Xyuas Kev Tswj Xyuas thiab Kev Siv Siv / Kev Pov Hwm Zoo (UR/QA) Kev Them Nyiaj Rov Qab Los Ntawm Kev Them Nyiaj Them Nqi thiab yuav tshaj tawm cov lus qhia ntxiv rau lub ncauj lus no thaum nws muaj.
Puas yog lub nroog puas yuav tsum ua kom tiav cov ntaub ntawv them nqi rau Kev Pabcuam Kev Tswj Xyuas thiab UR/QA?
Yog lawm, cov nroog yuav tsum xa daim ntawv xa nyiaj kawg uas qhia txog cov nqi tiag tiag los ntawm Lub Kaum Ob Hlis 31st tom qab kaw xyoo nyiaj txiag. Daim ntawv them nqi kawg yuav raug kuaj xyuas. Thov mus saib BHIN 23-049 yog xav paub ntxiv.
Cov kev tshuaj xyuas zoo li cas hauv cov txheej txheem qhia txog nqi tshiab?
Tam sim no DHCS tab tom ua haujlwm los ua kom tiav cov txheej txheem tshawb xyuas uas tsis muaj lub nra hnyav rau cov nroog dua li kev tshuaj xyuas yav dhau los. DHCS yuav tshaj tawm tsab ntawv ceeb toom ntawm cov ncauj lus no nrog kev taw qhia txog cov txheej txheem no uas yuav khaws tau feem ntau ntawm cov txheej txheem thov tam sim no.
Cov Kev Pabcuam Tswjhwm thiab URQA puas tuaj yeem tau txais kev pabcuam los ntawm Kev Pabcuam Kev Hloov Pauv (IGTs)? (Hloov kho 6/10/25)
Tsis yog. IGTs tsuas yog siv tau los pab nyiaj ncaj qha. DHCS tseem yuav tau lees paub cov kev siv nyiaj pej xeem raws li kev coj ua tam sim no. Cov Kev Pabcuam Tswjhwm thiab UR/QA cov txheej txheem them rov qab tsis tau hloov pauv raws li Kev Them Nyiaj Them Rov Qab. DHCS tau luam tawm BHIN 23-049 los qhia txog cov txheej txheem no. DHCS yuav tshaj tawm cov lus qhia ntxiv txog kev faib nqi rau cov kev pabcuam kev tswj hwm thiab UR/QA raws li Kev Them Nyiaj Them Rov Qab.
Vim li cas ho tsis cov nqi tshaj lij suav nrog hauv tus nqi kho mob?
Pib txij lub Xya Hli 1, 2023, Short-Doyle Medi-Cal (SD/MC) thiab Tus Nqi Them rau Kev Pabcuam Medi-Cal (FFS) cov tsev kho mob tau them rov qab rau cov nqi them rau cov kev pabcuam niaj hnub thiab lwm yam. Cov phiaj xwm kev puas siab puas ntsws (MHPs) them rov qab cov kev pabcuam kws tshaj lij uas muab rau hauv SD / MC thiab FFS cov tsev kho mob thiab xa cov ntaub ntawv thov nyiaj rov qab los ntawm tsoomfwv rau SD / MC thov kev pabcuam siv 837P.
DHCS tau siv qhov kev hloov pauv hauv SD/MC thaum lub Tsib Hlis 9, 2023 uas tso cai rau cov nroog tuaj yeem thov rau cov kev pabcuam tshaj lij hauv SD/MC cov tsev kho mob ua cov kev pabcuam sab nraud ntxiv rau cov kev pabcuam niaj hnub thiab lwm yam. SMHS Phau Ntawv Qhia Txog Kev Sau Nqi qhia txog qhov hloov tshiab no thiab tuaj yeem nrhiav tau ntawm Medi-Cal Lub Nroog Cov Kev Pabcuam Cov Neeg Siv Khoom (MedCCC) Library.
Cov nqi kws tshaj lij raug them rov qab raws li cov nqi kho mob sab nraud. Qhov no yog CMS qhov yuav tsum tau ua hauv kev pom zoo ntawm DHCS Lub Xeev Txoj Kev Hloov Kho 23- 015, tsis yog DHCS txoj cai. Lub nroog yuav raug them rau cov kev pabcuam kws tshaj lij uas siv cov nqi kho mob sab nraud uas tau tshaj tawm ntawm no.
Tus Nqi-For-Service (FFS) thiab Short-Doyle Medi-Cal (SD/MC) Cov Nqi Them Nqi Tsev Kho Mob Hnub Nyoog Li Cas rau cov neeg mob nyob hauv yuav raug them rov qab li cas?
Rau FFS cov tsev kho mob, kev txhim kho ntawm kev tswj hwm hnub tus nqi thiab nws cov txheej txheem tsis hloov pauv hauv 2023. DHCS yuav tshaj tawm tus nqi no txhua xyoo. Cov nqi tam sim no tau luam tawm ntawm no.
Raws li lub Xya hli ntuj 1, 2024, tib hnub kev tswj hwm tus nqi siv rau SD/MC tsev kho mob.
Puas yog NTP cov kev pab sab laj tuaj yeem them rov qab rau tib hnub li cov kev pabcuam hauv tsev? (Hloov kho 6/10/25)
DHCS paub hais tias cov chaw muab kev pab tej zaum yuav tau thov rau Narcotic Treatment Program (NTP) cov kev pab cuam rau ib tug tswv cuab Medi-Cal nyob rau tib hnub li lwm cov kev pab cuam Drug Medi-Cal Organized Delivery System (DMC-ODS), tshwj xeeb hauv kev kho mob hauv tsev, tsis kam lees. Raws li tau hais meej hauv MHSUD IN 17-039, thaum ib tus tswvcuab xav tau Cov Tshuaj Kho Mob rau Kev Kho Mob (MAT) raws li ib feem ntawm lawv txoj kev npaj khomob, cov kev pabcuam NTP (xws li kev txhaj tshuaj methadone, ib tus kws tshaj lij, thiab pab pawg sab laj) tau them rov qab rau tib hnub li lwm qhov kev pabcuam DMC-ODS los xyuas kom them nyiaj rau tag nrho cov kev pabcuam. DHCS tau hloov kho cov txheej txheem them nqi kom cov nroog xa ntawv thov rau cov kev pabcuam NTP nyob rau tib hnub raws li lwm cov kev pabcuam DMC-ODS hauv Short-Doyle Medi-Cal cov nqi them nqi yam tsis raug kaw. Cov kev hloov tshiab rau cov nqi them nqi tau siv rov qab ua haujlwm. Cov Rooj Pabcuam, uas tuaj yeem pom ntawm MedCCC Library, kuj tau hloov kho.
NTP Dosing Bundle suav nrog dab tsi?
Tus nqi tseem ceeb suav nrog hauv NTP dosing suav yog:
- Kev kuaj lub cev
- Tshuaj ntsuam xyuas
- Kev ntsuas kev noj haus
- Tus Thawj Coj Saib Xyuas Kev Kho Mob
- Tuberculosis (TB) Test
- Syphilis Test
- Kev kuaj HIV
- Hepatitis C Test
- Tshuaj ntsuam xyuas
- Daim Ntawv Tso Cai Ua Haujlwm Saib Xyuas Neeg Mob (LVN) Dosing
- Registered Nurse (RN) Dosing
- Cov nqi khoom xyaw
Rau cov khoom uas suav nrog hauv NTP tus nqi noj tshuaj xws li kev kuaj lub cev, cov chaw muab kev pabcuam thiab cov nroog tsis tuaj yeem sau cov nqi sib cais thiab sib nrug ntawm tus nqi bundled. NTP cov nqi tuaj yeem pom ntawm no.
Puas yog Kev Pabcuam Kev Saib Xyuas, Kev Pabcuam Rov Qab, thiab Tshuaj Kho Mob Ntxiv (MAT) suav nrog hauv DMC Residential Rate?
DHCS tau tso cai them nqi cais rau Kev Sib Koom Tes, Kev Pabcuam Rov Qab, thiab MAT ntxiv rau tus nqi tsev nyob ib ntus kom txog rau thaum muaj kev ceeb toom ntxiv. DHCS npaj siab los muab cov kev pabcuam no rau hauv cov nyiaj tau los ntawm qee lub sijhawm yav tom ntej thiab yuav sib tham txog qhov kev hloov pauv ua ntej nws yuav siv.
Puas yog cov kev pabcuam no (Kev Pabcuam Saib Xyuas, Kev Pabcuam Rov Qab, thiab MAT) ua tau raws li qhov yuav tsum tau ua txhua hnub yam tsawg kawg nkaus rau cov hnub nyob hauv tsev?
Yuav kom tau txais tus nqi nyob hauv ib hnub, tus neeg muab kev pabcuam hauv tsev yuav tsum muab yam tsawg kawg ib qho ntawm cov kev pabcuam hauv qab no: Kev soj ntsuam, kev sab laj, kev kho tsev neeg, kev pabcuam tshuaj, kev kawm rau tus neeg mob, lossis SUD kev pabcuam teebmeem teebmeem.
Kev Saib Xyuas Kev Sib Koom Tes, Cov Kev Pabcuam Tshwj Xeeb ntawm Kev Pabcuam, MAT rau Opioid Siv Disorder (OUD) thiab MAT rau Kev Siv Dej Haus (AUD) raug them rov qab cais tawm ntawm tus nqi diem.
Thaum muab los ntawm SUD qhov kev pab cuam nyob hauv tsev, cov kev pabcuam no puas tuaj yeem muab sau cia rau hauv daim ntawv ceeb toom txhua hnub ntev npaum li kev thov cais rau cov kev pabcuam ntawd?
DHCS yuav tsum muaj tsawg kawg yog ib daim ntawv qhia ua tiav rau cov kev pabcuam uas tau them nqi txhua hnub lossis raws li kev pabcuam. Daim ntawv ceeb toom kev kawm yuav tsum txhawb nqa cov kev pabcuam uas tau muab thiab suav nrog txhua qhov kev xav tau ntawm kev ua tiav tau teev tseg hauv BHIN 23-068. Piv txwv li, Therapeutic Foster Care (TFC) tau thov raws li 24-teev nce ntxiv, thiab yuav tsum muaj daim ntawv qhia ua tiav rau txhua qhov kev pabcuam xa. Cov ntawv ceeb toom kev nce qib txhua lub lim tiam lossis ib ntus tsis tuaj yeem siv los ntawm kev hloov pauv ntawm tus kheej cov ntaub ntawv kev nce qib rau txhua chav haujlwm.
Muaj qee qhov xwm txheej (kwv yees tsis tshua muaj) qhov kev pabcuam bundled yuav xa tuaj nrog rau qhov kev pabcuam thib ob uas tsis suav nrog tus nqi bundled thiab tuaj yeem thov cais. Nyob rau hauv cov ntaub ntawv no, kuj yuav tsum muaj ib tug ua tiav daim ntawv los txhawb qhov thib ob, unbundled kev pab cuam. Piv txwv li, Medi-Cal Peer Support Specialist cov kev pab cuam yuav raug thov nyob rau tib hnub li, thiab cais los ntawm, cov kev pab cuam nyob hauv tsev lossis ib hnub. Nyob rau hauv qhov xwm txheej no, DHCS yuav xav tau ib daim ntawv qhia ua tiav rau cov kev pabcuam hauv tsev lossis ib hnub, thiab ib daim ntawv qhia txog kev ua tau zoo los txhawb qhov kev thov ntxiv, uas tsis tau them rau Medi-Cal Peer Support Specialist cov kev pabcuam.
Cov kev cai no siv tau txawm hais tias cov kev pab cuam uas tau ntim thiab tsis tau muab los ntawm tib tus neeg muab kev pabcuam lossis los ntawm cov chaw muab kev pabcuam sib txawv.
Siv BHIN 23-068 & MedCCC Library uas muaj SMHS, DMC, thiab DMC-ODS phau ntawv sau nqi
Puas yog cov kev pabcuam tshuaj raug them se cais lossis suav nrog tus nqi pob?
Cov kev pabcuam tshuaj muaj qhov txawv ntawm MAT thiab suav nrog tus nqi bundled rau cov kev pabcuam nyob.
Dab tsi hloov pauv tau siv los txhim kho tus nqi ntsib? (Hloov kho 6/10/25)
DHCS tau hais txog ob lub Crisis Resource Need Calculator tsim los ntawm National Association of State Mental Health Directors (NASMHPD) thiab DHCS tsab ntawv ceeb toom hu ua "Tsuas Kev Tshawb Fawb Txog Kev Pabcuam Kev Noj Qab Haus Huv Kev Noj Qab Haus Huv hauv California" los txhim kho Mobile Crisis ntsib tus nqi.
Cov kev hloov pauv uas suav nrog hauv kev suav tus nqi suav nrog: kwv yees cov pab pawg Mobile Crisis xav tau raws li Crisis Resource Need Calculator, kwv yees lub sij hawm mus ncig, kwv yees tus naj npawb ntawm ntsib, county tus nqi ib teev rau Mobile Crisis teams thiab nruab nrab county tus nqi rau Mobile Crisis teams - ob qho tib si los ntawm FY 2023/24 MH/DMC Lub Sijhawm Kev Pabcuam Sab Nraud, R. Rau cov xyoo nyiaj txiag nram qab no, DHCS txhua xyoo hloov kho cov teeb meem mobile ntsib tus nqi uas siv Lub Chaw rau Medicare thiab Medicaid Services (CMS) Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv Hauv Tsev Market Basket Index kom suav nyiaj nce ntxiv.
Cov ntaub ntawv ntau ntxiv ntawm cov ntaub ntawv uas tau pab txhawb kev txhim kho tus nqi tuaj yeem pom ntawm no: BHIN 23-017.
Li cas mileage thiab tsheb thauj mus los suav rau?
Lub sij hawm thiab kev thauj mus los rau pab pawg mobile ntsoog yog tsim rau hauv tus nqi mobile ntsoog. Rau kev sib ntsib teeb meem ntawm lub xov tooj, qhov kev ncua deb tau them nqi thaum pab pawg Mobile Crisis npaj rau tus neeg mob thauj mus rau qib siab ntawm kev saib xyuas siv HCPCS code A0140 (Kev thauj mus los, mais). Lub sijhawm nws yuav siv rau kev thauj mus los no thiab kev ua haujlwm sov tuaj yeem them nqi raws li HCPCS code T2007 (Kev thauj mus los, sijhawm tos).
Xav paub ntau ntxiv ntawm cov lej sau nqi ntsig txog Mobile Crisis tuaj yeem pom hauv MedCCC Library.
Puas yuav tus nqi rau EMT thiab cov kws kho mob yuav muab ntxiv rau tus nqi tam sim no?
Tsis yog, cov nqi tam sim no rau HCPCS cov lej tsheb thauj mus los (A0140) thiab lub sijhawm tos tsheb thauj mus los (T2007) tsis yog raws li tus neeg muab kev pabcuam. Rau cov lej no, muaj ib tus nqi ntawm ib lub nroog thiab txhua tus neeg muab kev pabcuam uas yog ib feem ntawm pab pawg teebmeem mobile yuav siv cov lej no.
Vim li cas DHCS thiaj li tshaj tawm cov nqi rau kev nthuav dav DMS-ODS Services rau txhua lub nroog DMC (State Plan)?
Raws li BHIN 22-003, "Cov neeg tau txais txiaj ntsig hnub nyoog qis dua 21 xyoos muaj cai tau txais tag nrho cov kev pabcuam khomob uas tsim nyog tau txais kev pabcuam hauv qab 42 USC § 1396d(a) txawm tias cov kev pabcuam nyob hauv lub xeev Medicaid Plan, suav nrog tag nrho cov kev pabcuam DMC-ODS, txawm tias lawv nyob hauv DMC lub nroog." Yog li ntawd, DMC-State Plan counties yuav tsum tau muab cov kev pab cuam DMC-ODS rau EPSDT cov neeg tau txais txiaj ntsig (piv txwv li, cov neeg tau txais txiaj ntsig qis dua 21 xyoos rau npe rau tag nrho cov kev pab cuam code).
Puas yog cov nqi them rau cov nroog suav nrog lub sijhawm mus ncig thiab cov ntaub ntawv?
Hauv kev txhim kho CalAIM Tus Cwj Pwm Kev Noj Qab Haus Huv Kev Them Nyiaj Them Nqi Them Nqi Them Cov Neeg Mob Sab Nraud, DHCS tau sau cov ntaub ntawv tus nqi los ntawm SMHS cov kws kho mob ncaj qha hauv txhua lub nroog rau SFY 2020-21. Cov ntaub ntawv suav nrog cov nqi pab neeg ua haujlwm, kev saib xyuas hauv tsev kho mob thiab cov nqi them nyiaj rau cov neeg ua haujlwm, cov nqi khiav haujlwm hauv tsev kho mob, thiab cov nqi kho mob tsis ncaj. DHCS siv cov ntaub ntawv no los ua lub hauv paus ntawm cov nqi thauj khoom tag nrho rau cov kev pab cuam sab nraud. Tus nqi thauj khoom tag nrho rau cov neeg ua haujlwm siv sijhawm rau kev saib xyuas tus neeg mob ncaj qha; lub sijhawm cov neeg ua haujlwm tsis siv rau kev saib xyuas tus neeg mob ncaj qha (piv txwv li, lub sijhawm siv rau cov ntaub ntawv, mus ncig, thiab lub sijhawm them nyiaj so haujlwm); tag nrho cov nyiaj them rau cov neeg ua haujlwm (xws li cov nyiaj hli thiab cov nyiaj ua haujlwm, cov txiaj ntsig, nyiaj tshwj xeeb, thiab lwm yam kev txhawb siab); thiab txhua qhov ncaj thiab tsis ncaj nyiaj siv ua haujlwm thiab cov nqi khiav haujlwm.
Qhov tseem ceeb, kom tsis txhob muaj kev tsis txaus siab rau kev xa cov kev pabcuam hauv chaw kho mob uas tsim nyog, cov nroog yuav tsum xav txog kev siv tus nqi sib txawv / kev txhim kho uas suav nrog cov qauv tsim tau qis dua thiab lub sijhawm mus ncig thiab cov nqi cuam tshuam nrog kev pabcuam hauv tsev, kev pabcuam hauv kev, thiab kev pabcuam xa tawm. nyob rau hauv lwm qhov chaw tsis kho mob hauv zej zog
Dab tsi yog qhov zoo tshaj plaws ntawm CPT Code cov ntaub ntawv uas cov nroog yuav tsum sab laj tsis tu ncua rau cov kev coj ua uas tsim nyog?
Lub koom haum American Medical Association's (AMA) CPT codebooks muab cov lus piav qhia ntau ntxiv ntawm CPT cov lej thiab cov txheej txheem kev cai tswj hwm kev siv thiab xaiv. CPT codebook yuav pab teb cov lus nug xws li: cov kev pab cuam twg muaj ib txoj cai encompasses, yuav ua li cas xaiv ib chav tsev ntawm ib tug code thiab cov chaw muab kev pab yuav thov rau ib qho kev pab cuam.
Ib lo lus nug uas DHCS tau txais yog thaum twg ib chav tsev ntawm lub sij hawm rau ib txoj cai tshwj xeeb yuav tsum tau thov. 2024 CPT codebook hais tias: “Lub CPT code teeb muaj ntau tus lej nrog lub sijhawm rau kev xaiv. Cov qauv hauv qab no yuav tsum siv rau kev ntsuas lub sijhawm, tshwj tsis yog tias muaj cov cai lossis cov lus qhia tshwj xeeb hauv cov lus qhia, cov lus qhia hauv kab lus, lossis cov lus piav qhia txog qhov tsis sib xws. Ib chav tsev ntawm lub sij hawm yog attained thaum lub mid-point dhau. Piv txwv li, ib teev tau txais thaum 31 feeb tau dhau mus (ntau tshaj qhov nruab nrab ntawm xoom thiab 60 feeb). Ib teev thib ob tau txais thaum tag nrho ntawm 91 feeb tau dhau mus. " Ib yam li ntawd, muaj kev nug txog seb cov kev pab cuam cuam tshuam nrog kev ntsuam xyuas thiab kev tswj hwm CPT cov lej 99202-99215 puas tuaj yeem "suav nrog kev sau tshuaj uas cuam tshuam txog kev siv cawv." Nplooj 14 ntawm 2024 CPT codebook teev cov kev pabcuam uas suav nrog hauv txhua qhov kev ntsuam xyuas thiab kev tswj xyuas cov lej thaum cov lej raug xaiv raws sijhawm. "Kev xaj tshuaj, kev sim, lossis cov txheej txheem" yog ib qho ntawm cov kev pabcuam uas tau teev tseg.
Thov nco ntsoov tias DHCS cov cai yuav muaj kev txwv ntau dua li cov cai tau piav qhia hauv CPT codebook. Yog li ntawd, CPT codebook yuav tsum tau siv ua ke nrog rau cov ntawv sau nqi, nyob ntawm no.
Cov kws kho mob puas tuaj yeem sau nqi rau cov kev pabcuam thaum tus tswvcuab tsis nyob?
Yog tias tus lej nyiaj them nqi kho mob yog tus tswvcuab txoj cai them tus nqi pabcuam, lub sijhawm txhais tau tias lub sijhawm siv nrog tus tswvcuab rau lub homphiaj muab kev khomob. Yog tias tus lej sau nqi qhia txog cov haujlwm uas tsis yog kev saib xyuas tus tswvcuab ncaj qha tab sis yog rau cov txiaj ntsig ntawm tus tswvcuab lossis tus tswvcuab cov neeg txhawb nqa, cov haujlwm no raug tso cai, tsuav yog ua haujlwm uas yuav raug them nqi yog tias tus tswvcuab tuaj. Piv txwv li, CPT code 99202 (chaw ua haujlwm lossis lwm qhov kev mus ntsib tus neeg mob sab nraud) suav nrog "keeb kwm kho mob thiab/lossis kev kuaj mob" uas yog ib feem ntawm cov kev pabcuam uas tau piav qhia los ntawm tus lej. Raws li Txoj Cai Kev Ntsuas thiab Kev Tswj Xyuas Kev Pabcuam hauv 2024 CPT codebook, qhov no txhais tau tias "pab neeg saib xyuas tuaj yeem sau cov ntaub ntawv, piv txwv li, los ntawm hluav taws xob kev noj qab haus huv portal lossis daim ntawv nug." Yog tias sib sau ua ke thiab sib sau ua ke cov ntaub ntawv kho mob uas yog ib feem ntawm tus tswv cuab cov ntaub ntawv kho mob los ua cov lus pom zoo rau kev kho mob lossis kuaj xyuas kev kho mob, ces qhov kev ua haujlwm yuav suav tias yog lub sijhawm pabcuam thiab thov tau txawm tias tus tswvcuab tsis tuaj. Yog tias qhov kev pabcuam code sau npe qhia txog qhov kev pabcuam kev tswjfwm lossis kev pabcuam sablaj sawv cev ntawm tus tswvcuab, cov haujlwm no raug tso cai. Nyob rau hauv cov xwm txheej no, lub sij hawm kev pab them nqi yog lub sij hawm siv kev sab laj sawv cev ntawm cov tswv cuab nrog cov kws tshwj xeeb thiab/los yog nrog tus tswv cuab cov neeg txhawb nqa. Lub sij hawm txais kev pab cuam tsis suav nrog lub sij hawm mus ncig, kev tswj xyuas, kev tshuaj xyuas kab ntawv, cov ntaub ntawv, kev tshuaj xyuas kev siv thiab kev tuav pov hwm zoo lossis lwm yam dej num uas tus kws kho mob koom nrog uas twb tau suav nrog tus nqi rau kev pabcuam lossis raug thov cais los ntawm lub nroog.
Puas yog DHCS muab lossis pom zoo rau Electronic Health Records (EHR) cov txheej txheem ntawm kev them nqi?
Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv Hauv Nroog yog lub luag haujlwm rau kev xaiv thiab kev yuav khoom ntawm EHR thiab lwm yam IT infrastructure. DHCS tsis muab cov peev txheej no thiab tsis pom zoo lossis pom zoo ib yam khoom lossis tus neeg muag khoom tshwj xeeb. Lub nroog yuav tsum xaiv tus neeg muag khoom thiab cov khoom lag luam uas haum rau cov kev xav tau thiab cov peev txheej nyiaj txiag ntawm lub nroog.
Cov chaw muab kev pabcuam thiab cov nroog tuaj yeem nrhiav BH cov ntaub ntawv hloov kho kev them nyiaj nyob qhov twg?
DHCS tau cog lus nrog Catalyst Center los tsim cov kev cob qhia online rau Medi-Cal cov chaw muab kev pabcuam thiab lub nroog BH cov chaw haujlwm ntsig txog BH Kev Hloov Kho Kev Them Nyiaj.
Slides thiab kaw cov kev cob qhia hauv cov yeeb yaj kiab no tuaj yeem nkag mus tau los ntawm kev tsim tus account pub dawb ntawm: https://www.catalyst-center.org/learnupon. Siv lo lus "Payment Reform Series" hauv Catalog search functionn nrhiav kev cob qhia lossis hu rau Catalyst Center ntawm youth@catalyst-center.org kom paub ntau ntxiv txog kev nkag mus rau cov kev cob qhia no.
Lub Catalyst Center BH Kev Them Nyiaj Hloov Kho Kev cob qhia hais txog cov ncauj lus hauv qab no:
Kev Hloov Kho Kev Ua Haujlwm (Lub Peb Hlis 6, 2025): Lub hom phiaj thiab lub hom phiaj ntawm Kev Hloov Kho Kev Them Nyiaj, npaj rau kev them nqi raws li tus nqi, kev hloov kho kev pabcuam, cuam tshuam rau kev ua haujlwm hauv cheeb tsam, ua kom yooj yim cov ntaub ntawv, thiab kev hloov pauv kab lis kev cai tsim nyog.
CPT Basics thiab Common Challenges (Lub Peb Hlis 27, 2025): Cov Txheej Txheem Txheej Txheem Tam Sim No (CPT ® ) cov lej siv hauv SMH thiab DMS-ODS cov kev pabcuam, kev kaw haujlwm, siv cov kev hloov pauv, kev hloov pauv rau cov kev pabcuam nyiaj txiag, kev them nqi lossis sijhawm tsis tau them nqi, thiab cov tswv yim coding zoo siv cov piv txwv.
QA thiab Kev Them Nqi Zoo Tshaj Plaws (Lub Plaub Hlis 24, 2025): Cov ntaub ntawv hloov pauv, Kev Tswj Xyuas Zoo (QA) kev hloov kho (nrog rau kev ua haujlwm QA kom muaj kev ruaj ntseg nyiaj txiag), kev them nqi / thov cov kev coj ua zoo tshaj plaws, EHR cov ntawv ceeb toom, kev lees paub kev sib haum xeeb, thiab kev tswj tsis lees paub.
Kev tswj kom ua tiav (Tsib Hlis 22, 2025): Cov tswv yim saib xyuas cov txheej txheem suav nrog cov qauv nqi, kev xam tus nqi ntawm tus kws kho mob, cov tswv yim sib tham txog kev cog lus, kev tswj cov khoom lag luam, kev zam kev kaw, kev sib koom ua ke hauv xov tooj, thiab kev hloov pauv kev ua haujlwm.
Cov Ntsiab Lus thiab Kev Sib Tham (Lub Rau Hli 26, 2025): Kev tshuaj xyuas cov ntsiab lus tseem ceeb los ntawm cov kev sib tham ua ntej ntsig txog BH kev hloov kho kev them nyiaj, CPT ® code ceeb toom, Lub Xya Hli hloov tshiab hauv cov lej rau Cov Kev Pabcuam Hauv Zej Zog, kev sib tham ntawm coding scenarios, thiab teb cov lus nug.
Yuav ua li cas cov nroog tuaj yeem thov rau cov kev pabcuam kho mob los ntawm cov tub ntxhais kawm qib siab thiab cov tub ntxhais kawm PhD uas tsis tau ntawv tso cai ua haujlwm hauv kev xyaum ua haujlwm? (Hloov kho 6/10/25)
Hauv California, cov tub ntxhais kawm ntawv qib siab thiab cov tub ntxhais kawm tsis tau ntawv tso cai PhD uas ua haujlwm hauv kev xyaum ua haujlwm tuaj yeem muab kev kho mob hauv lawv qhov kev coj ua raws li kev saib xyuas ntawm tus kws tshaj lij kev noj qab haus huv uas muaj ntawv tso cai. Lub Chaw Pabcuam Medicare & Medicaid (CMS) tau pom zoo California Txoj Kev Npaj Khomob Xeev (SPA) uas qhia meej txog lub luag haujlwm ntawm cov tub ntxhais kawm xyaum ua haujlwm raws li SMHS thiab DMC/DMC-ODS cov chaw muab kev pabcuam. Hnub ua haujlwm ntawm SPA tau rov ua haujlwm rau Lub Xya Hli 1, 2023.
DHCS tau hloov kho qhov Short-Doyle Medi-Cal thov kom tso cai rau cov tub ntxhais kawm ntawv qib siab thiab cov tub ntxhais kawm tsis tau ntawv tso cai PhD uas ua haujlwm hauv kev xyaum ua haujlwm kom siv cov cai uas tsim nyog rau kev thov nyiaj rov qab thiab muab cov nqi them nqi kho mob hauv nroog rau cov tub ntxhais kawm uas ua haujlwm hauv kev xyaum ua haujlwm. Lub nroog tuaj yeem xa cov ntawv thov rau cov tub ntxhais kawm lossis hloov cov ntawv tsis lees paub rau cov hnub ua haujlwm rau lossis tom qab Lub Xya Hli 1, 2023, raug txwv sijhawm thov.
Cov tub ntxhais kawm muab kev pabcuam khomob hauv lawv qhov kev coj ua yuav tsum siv cov lej CPT uas tsim nyog nrog HL hloov kho los thov kom them rov qab thiab suav nrog lawv Tus Kws Kho Mob Hauv Tebchaws (NPI) thiab cov lej sau se ntawm lawv tus kws kho mob saib xyuas.
Hauv lub nroog twg yuav tsum thov kev txhais lus ntawm qhov ncauj lossis txhais tes?
Daim ntawv thov kev txhais lus yuav tsum raug xa thaum tus kws kho mob thiab tus neeg mob tsis tuaj yeem sib txuas lus ua ib hom lus, thiab tus kws kho mob siv tus neeg txhais lus nyob rau ntawm qhov chaw thiab/los yog tus neeg tau txais kev pab txhais lus kho mob los muab kev txhais lus kho mob.
Lub sij hawm txhais lus yuav tsis pub tshaj lub sij hawm siv muab kev pab cuam. Piv txwv li, yog tias kev kho mob kav ntev li 45 feeb, qhov siab kawg ntawm peb chav nyob ntawm T1013 tuaj yeem thov.
Kev txhais lus yuav tsis raug thov thaum tus neeg mob pw hauv tsev kho mob lossis tsev nyob vim tias tus nqi ntawm kev txhais lus suav nrog tus nqi tsev nyob hauv Drug Medi-Cal (DMC) lossis Specialty Mental Health (SMH) systems. Kev txhais lus kuj tsis tuaj yeem thov rau kev siv tshuab / digital txhais lus lossis kev pabcuam relay.
Qhov twg taxonomy code yuav tsum muaj nyob rau hauv daim ntawv thov kev pab txhais lus? (Hloov kho 9/10/24)
Kev thov rau kev txhais lus, T1013 (cov lus piav tes lossis cov kev pabcuam txhais lus ntawm qhov ncauj), yuav tsum suav nrog cov lej sau se thiab NPI ntawm tus neeg uas muab kev pabcuam thawj zaug. Tus qauv tus nqi ib chav tsev ntawm qhov ncauj lossis txhais lus txhais lus yog nyob ntawm Bureau of Labor Statistics cov ntaub ntawv. Ib chav tsev ntawm T1013 tau them rov qab ntawm $ 30.
Puas yog Medi-Cal them thiab them rov qab rau cov kev pabcuam uas muab rau tus neeg tau txais kev pab txhawb nqa thaum tsis muaj tus neeg txais txiaj ntsig?
Yog lawm, qee qhov kev pabcuam Medicaid suav nrog cov kev pabcuam muab rau tus neeg tau txais txiaj ntsig cov kev txhawb nqa thaum tus neeg txais txiaj ntsig tsis nyob. Ntxiv 3 rau Daim Ntawv Cuam Tshuam 3.1-A piav qhia txog Cov Kev Pabcuam Kev Puas Siab Puas Hlwb Tshwj Xeeb (SMHS), Kev Pabcuam Kev Siv Tshuaj Tiv Thaiv Kabmob (DMC), thiab Kev Pabcuam Kev Siv Tshuaj Tiv Thaiv Kabmob (DMC-ODS) uas muaj rau cov neeg tau txais txiaj ntsig Medicaid (Medi-Cal). Cov kev pab them nqi no yuav suav nrog kev sib cuag nrog cov neeg txhawb nqa tseem ceeb lossis lwm yam kev lav phib xaub uas koom nrog hauv kev npaj thiab kho tus neeg tau txais txiaj ntsig. Yog tias qhov kev pab them nqi xav kom tus neeg tau txais txiaj ntsig tuaj, ces qhov kev sib cuag nrog nyiaj txiag yuav tsum tshwm sim thaum tus neeg txais txiaj ntsig tuaj. Yog tias qhov kev pab them nqi tsis xav kom tus neeg tau txais txiaj ntsig tuaj, qhov kev tiv tauj yuav tshwm sim thaum tus neeg txais txiaj ntsig tsis nyob. Cov ntaub ntawv kho tshiab DHCS Short Doyle Medi-Cal Phau Ntawv Qhia muaj nyob ntawm no. Cov lej cuam tshuam nrog cov chaw muab kev pabcuam tshiab hauv SMHS Delivery System tuaj yeem pom ntawm no.
Cov Kws Lij Choj Ua Haujlwm Li Cas (LVNs) thiab Cov Kws Lij Choj Psychiatric (LPTs) tuaj yeem muaj kev kawm thiab ntawv pov thawj, nyob rau hauv kev saib xyuas ntawm Tus Kws Saib Xyuas Kev Noj Qab Haus Huv lossis Tus Kws Kho Mob, muab tshuaj noj hauv qhov ncauj lossis tso ntshav rau cov neeg mob hauv Kev Pabcuam Kev Noj Qab Haus Huv Tshwj Xeeb? (Hloov kho 9/10/24)
LVNs thiab LPTs tau lees paub cov neeg muab kev pabcuam hom SMHS nyob rau hauv lawv qhov kev coj ua, raws li tau tsim nyob rau hauv Ntxiv 3 rau Kev Txuas 3.1-A ntawm California Txoj Kev Npaj Khomob Medicaid.
Lawv tuaj yeem muab tshuaj ntxiv thiab tuaj yeem thov kom ua li ntawd. Thov xa mus rau cov Table Service tam sim no, pom nyob rau hauv MedCCC Library, rau cov lej LVNs thiab LPTs tuaj yeem thov.
Puas yog LVNs thiab LPTs lees paub cov chaw muab kev pabcuam DMC thiab DMC-ODS? (Hloov kho 6/10/25)
Yog lawm. CMS tau pom zoo State Plan Amendment (SPA) 23-0026 uas tau ntxiv LVNs thiab LPTs rau hauv cov npe ntawm cov neeg muab kev pabcuam uas lees paub rau DMC thiab DMC-ODS cov kev pabcuam. SPA tau siv rau lub Xya Hli 1, 2023. DHCS tau hloov kho qhov Short-Doyle Medi-Cal (SD/MC) kev thov nyiaj rov qab rau cov kev pab cuam DMC thiab DMC-ODS uas tau muab los ntawm LVNs rov qab rau lub Xya Hli 1, 2023.
Puas yog Medical Assistants (MAs) lees paub cov kev pabcuam SMHS, DMC, thiab DMC-ODS? (Hloov kho 5/30/25)
Yog lawm. CMS tau pom zoo State Plan Amendment (SPA) 23-0026 uas tau ntxiv MAs rau hauv cov npe ntawm cov chaw muab kev lees paub rau SMH, DMC, thiab DMC-ODS cov kev pabcuam. SPA tau siv rau lub Xya Hli 1, 2023. DHCS kuj tau hloov kho qhov Short-Doyle Medi-Cal (SD/MC) kev thov nyiaj rov qab rau cov neeg mob sab nraud SMH, DMC, thiab DMC-ODS cov kev pabcuam muab los ntawm MAs rov qab mus rau Lub Xya Hli 1, 2023.
Lub nroog puas yuav raug them rov qab rau lub sijhawm npaj mus ntsib tus neeg mob thiab lub sijhawm siv rau kev ua haujlwm tom qab?
Lub nroog yuav tsum tsuas yog xav txog lub sijhawm saib xyuas tus neeg mob ncaj qha, raws li tau hais tseg hauv phau ntawv sau nqi, thaum xaiv tus lej tsim nyog tshaj plaws rau daim nqi. Txawm li cas los xij, qhov no tsis tau txhais hais tias cov nroog yuav tsis raug them rov qab rau cov dej num xws li kev tshuaj xyuas daim ntawv qhia, cov ntaub ntawv, thiab lwm yam dej num cuam tshuam nrog kev npaj mus ntsib tus neeg mob lossis lub sijhawm ua haujlwm tom qab. Cov nqi DHCS them rau cov nroog raug hloov kho kom suav nrog cov nqi rau cov neeg ua haujlwm lub sijhawm tsis siv rau kev saib xyuas tus neeg mob ncaj qha, uas suav nrog cov haujlwm uas tus kws kho mob koom ua ntej thiab tom qab pom tus neeg mob, thiab "tsis muaj kev qhia".
Lub nroog yuav thov li cas rau cov kev pabcuam pab pawg yog tias tib tus neeg tau txais txiaj ntsig tau pom nyob rau hauv ob peb pawg sib tham nyob rau tib hnub? (Hloov kho 6/10/25)
Raws li CalAIM, yog tias tus neeg muab kev pabcuam muab ob qhov kev pabcuam khomob sab nraud rau tib tus neeg tau txais txiaj ntsig nyob rau tib hnub hauv ob lossis ntau qhov kev sib ntsib sib cais, txhua qhov kev sib ntsib yuav tsum raug lees paub tias yog ib qho kev pabcuam kom ntseeg tau tias qhov kev sib ntsib ntxiv tsis raug tsis lees paub raws li kev pabcuam sib npaug.
Txawm li cas los xij, DHCS lees paub tias nws tuaj yeem taug qab tsis yooj yim thaum tus neeg tau txais txiaj ntsig tau pom nyob rau hauv ob peb pawg sib tham nyob rau tib hnub. Yog li ntawd, DHCS tau hloov kho qhov Short-Doyle Medi-Cal qhov kev thov kom tso cai rau cov nroog los thov cov nyiaj them rov qab rau ntau tshaj ib pab pawg muab kev pabcuam rau tib tus neeg tau txais txiaj ntsig los ntawm tib tus kws kho mob nyob rau tib hnub. Lub nroog tuaj yeem thov ntau dua ib zaug rau tib tus neeg tau txais txiaj ntsig, nyob rau tib hnub, rau kev pabcuam pab pawg .
Cov kws kho mob twg tshiab tsim nyog thov rau cov kev pabcuam hauv Cov Kev Pabcuam Kev Puas Hlwb Tshwj Xeeb (SMHS), Tshuaj Medi-Cal (DMC)-Organized Delivery System (ODS), thiab DMC cov txheej txheem xa khoom?
Lub Xeev Txoj Kev Npaj Kho Mob (SPA) 23-0026 tau ntxiv cov hom kev muab kev pab cuam uas tau teev tseg hauv qab no rau Short-Doyle thov qhov system, pib lub Xya hli ntuj 1, 2023.
Cov neeg muab kev pabcuam tshiab tsim nyog thov rau cov kev pabcuam hauv SMHS kev xa khoom yog:
- Medical Assistant (MA)
- Nurse Practitioner/Clinical Nurse Specialist Clinical Trainee
- Psychologist Clinical Trainee
- Clinical Social Worker (LCSW) Clinical Trainee
- Kev Sib Yuav thiab Tsev Neeg Therapist (MFT) Clinical Trainee
- Tus Kws Pab Tswv Yim Kho Mob (LPCC) Cov Kws Kho Mob
- Psychiatric Technician Clinical Trainee
- Registered Nurse (RN) Clinical Trainee
- Cov Kws Kho Mob Kws Kho Mob Ua Haujlwm
- Occupational Therapist Clinical Trainee
- Pharmacist Clinical Trainee
- Kws Kho Mob Assistant (PA) Clinical Trainee
- Medical Student in Clerkship (Physician Clinical Trainee)
Cov neeg muab kev pabcuam tshiab tsim nyog thov hauv DMC thiab DMC-ODS cov khoom xa tuaj yog:
- Tus kws kho mob
- Tus kws kho mob ua haujlwm
- Daim Ntawv Tso Cai Ua Haujlwm Ua Haujlwm
- Daim ntawv tso cai Psychiatric Technician
- Nurse Practitioner Clinical Trainee
- Psychologist Clinical Trainee
- Clinical Social Worker (LCSW) Clinical Trainee
- Kev Sib Yuav thiab Tsev Neeg Therapist (MFT) Clinical Trainee
- Tus Kws Pab Tswv Yim Kho Mob (LPCC) Cov Kws Kho Mob
- Psychiatric Technician Clinical Trainee
- Registered Nurse Clinical Trainee
- Cov Kws Kho Mob Kws Kho Mob Ua Haujlwm
- Occupational Therapist Clinical Trainee
- Pharmacist Clinical Trainee
- Tus kws kho mob Assistant Clinical Trainee
- Medical Student in Clerkship (Physician Clinical Trainee)
Clinical Trainee yog dab tsi?
Tus Kws Qhia Tshuaj Kho Mob yog ib tus neeg tsis muaj ntawv tso cai uas tau tso npe rau hauv kev kawm qib siab tom qab kawm tiav hauv Xeev California uas yuav tsum muaj rau tus neeg tau txais daim ntawv tso cai raws li Daim Ntawv Tso Cai Kev Kho Mob Puas Hlwb lossis Daim Ntawv Tso Cai Kho Mob; yog koom nrog hauv kev xyaum, kev ua haujlwm, lossis kev xyaum ua haujlwm tau pom zoo los ntawm tus kheej txoj haujlwm; thiab ua tau raws li txhua qhov kev xav tau ntawm txoj haujlwm thiab / lossis daim ntawv tso cai siv tau los koom rau hauv kev xyaum, kev ua haujlwm lossis kev xyaum ua haujlwm thiab muab kev pabcuam khomob puas hlwb lossis kev pabcuam tshuaj siv tshuaj, suav nrog, tabsis tsis txwv rau, tag nrho cov kev kawm thiab kev saib xyuas kev coj ua.
Thaum thov rau cov kev pab cuam los ntawm Clinical Trainees, dab tsi taxonomy codes, modifiers thiab cov ntaub ntawv ntxiv yuav tsum tau tshaj tawm ntawm 837P?
Thaum thov rau cov kws kho mob, MHPs, DMC-ODS counties, DMC counties thiab trading cov neeg koom tes yuav tsum tau qhia taxonomy code nrog thawj plaub lub cim 1774 rau cov tub ntxhais kawm kho mob nyob rau hauv clerkship los yog 3902 rau tag nrho cov lwm yam kev kho mob trainees, nrog rau cov txheej txheem tsim nyog code modifier raws li qhia hauv qab no los txheeb xyuas hom kws kho mob trainee. Piv txwv li, txhawm rau thov kev ntsuam xyuas kev puas siab puas ntsws (CPT code 90791), Tus Neeg Ua Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (Social Worker Clinical Trainee) yuav siv taxonomy code 3902 thiab thov rau kev soj ntsuam kev puas siab puas ntsws, siv cov txheej txheem code: modifier ua ke 90791: AJ.
Ntxiv nrog rau kev siv cov kev sau se uas tsim nyog thiab tus txheej txheem kev hloov kho, tus thawj saib xyuas lub National Provider Identifier (NPI) kuj tseem yuav tsum muaj rau txhua qhov kev thov rau cov kev pabcuam los ntawm Cov Kws Kho Mob.
Tsis muaj. | Txoj hauj lwm (s) Hom | Taxonomy | Hloov kho |
1. | Tub Kawm Ntawv Kho Mob hauv Clerkship | 1744 | Tsis muaj |
2. | LCSW, MFT lossis LPCC Clinical Trainee | 3902 | AJ |
3. | Psychologist Clinical Trainee | 3902 | AH |
4. | Registered Nurse Clinical Trainee | 3902 | TD |
5. | Cov Kws Kho Mob Kws Kho Mob Ua Haujlwm | 3902 | TE |
6. | Psychiatric Technician Clinical Trainee | 3902 | HM |
7. | Occupational Therapist Clinical Trainee | 3902 | CO |
8. | Nurse Practitioner/Clinical Nurse Specialist Clinical Trainee | 3902 | HP |
9. | Pharmacist Clinical Trainee | 3902 | HO |
10. | Tus kws kho mob Assistant Clinical Trainee | 3902 | Tsis muaj |
Thaum thov rau cov kev pabcuam uas tau muab los ntawm Tus Kws Lij Choj Kho Mob, qhov twg yuav tsum tau tshaj tawm tus thawj saib xyuas NPI?
Thaum thov rau cov kev pab cuam muab los ntawm Clinical Trainee, tus thawj saib xyuas lub NPI yuav tsum tau tshaj tawm nyob rau theem thov (loop 2310D) thiab/los yog nyob rau theem kev pabcuam (loop 2420D). Yog tias Clinical Trainee muaj NPI, lawv yuav tsum tau tshaj tawm nws. Cov ntsiab lus tshwj xeeb ntawm yuav ua li cas qhia tus kws kho mob NPIs ntawm 837P cov lus thov raug sau tseg nyob rau hauv ASCX12 5010 Cov Lus Qhia Txog Kev Ua Haujlwm muaj rau kev yuav khoom ntawm http://www.wpc-edi.com. Kev thov rau cov kev pabcuam muab los ntawm Cov Kws Kho Mob uas tsis qhia tus saib xyuas lub NPI yuav raug tsis lees paub. Lub nroog yuav tsum xyuas kom meej tias tus kws kho mob saib xyuas Cov Kws Kho Mob ua tau raws li cov kev tsim nyog yam tsawg kawg nkaus uas tau piav qhia los ntawm pawg tswj hwm daim ntawv tso cai.
Short Doyle yuav lees paub tus thawj saib xyuas NPI tawm tsam cov ntaub ntawv hauv National Plan & Provider Enumeration System (NPPES). Kev thov rau Cov Kws Kho Mob uas tsis muaj tus saib xyuas siv tau NPI yuav raug tsis kam lees nrog pab pawg hloov kho, cov laj thawj code, thiab cov lus ceeb toom code CO/208/N297.
Thaum thov rau cov kev pab cuam los ntawm Clinical Trainees, puas muaj leej twg hauv lub luag haujlwm saib xyuas tuaj yeem tshaj tawm txog qhov kev thov?
Txhua qhov chaw uas tau hais hauv daim ntawv no, "tus saib xyuas" yog hais txog tus kws kho mob uas muaj ntawv tso cai koom nrog kos npe rau cov ntawv ua tiav. Tus kws kho mob muaj ntawv tso cai kos npe rau cov ntawv sau ua tiav lees paub lub luag haujlwm rau cov kev pabcuam uas tus kws kho mob tau muab rau hnub pabcuam ntawd, thiab tus neeg no tus NPI yuav tsum yog NPI qhia hauv voj 2310D thiab / lossis voj 2420D ntawm 837P.
Tus Kws Kho Mob txhais li cas?
Lub Xeev Txoj Kev Hloov Kho (SPA) 23-0026 txhais tau tias Tus Pab Kho Mob yog ib tus neeg muaj hnub nyoog tsawg kawg yog 18 xyoo, ua tau raws li tag nrho cov kev kawm, kev cob qhia thiab / lossis cov ntawv pov thawj uas yuav tsum tau ua thiab muab kev pabcuam kev tswj hwm, tus thawj coj, thiab kev pabcuam kev pabcuam, raws li lawv txoj haujlwm ntawm kev coj ua, nyob rau hauv kev saib xyuas ntawm tus kws kho mob muaj ntawv tso cai, kws kho mob lossis kws phais neeg mob hauv xeev. tus kws kho mob lossis tus kws pab kho mob uas tau tso cai saib xyuas los ntawm tus kws kho mob thiab kws phais. Tus kws kho mob thiab kws phais neeg muaj ntawv tso cai, tus kws kho mob, lossis tus kws kho mob yuav tsum muaj lub cev nyob hauv lub chaw kho mob (chaw kho mob lossis chaw kho mob) thaum muab kev pabcuam los ntawm tus kws pab kho mob.
Lub nroog twg yuav tsum siv cov lej se los thov rau cov kev pabcuam uas muab los ntawm Tus Pabcuam Khomob?
Short Doyle siv tsib tus lej validation rau taxonomy code rau Medical Assistants. Cov phiaj xwm kev puas siab puas ntsws (MHP), DMC-ODS counties, DMC counties thiab cov koom tes ua lag luam yuav tsum siv cov lej sau se uas thawj tsib lub cim pib nrog 363AM rau Cov Pabcuam Kho Mob. Thov nco ntsoov tias tag nrho cov cai sau se pib nrog 363A qhov twg tus cim thib tsib tsis yog "M" yuav txuas ntxiv mus rau daim ntawv qhia rau tus kws kho mob pab hom hauv Short Doyle.
DMC thiab DMC-ODS counties yuav siv li cas los thov rau cov kev pab cuam los ntawm tus kws kho mob muaj ntawv tso cai, kws kho mob muaj ntawv tso cai, thiab cov kws kho mob puas siab puas ntsws hauv DMC-ODS thiab DMC kev xa khoom?
DMC-ODS counties, DMC counties, thiab trading cov neeg koom tes yuav tsum siv tib lub taxonomy codes rau cov chaw muab kev pab raws li tam sim no siv los ntawm Mental Health Plans (MHPs) nyob rau hauv lub SMHS xa system. Thawj plaub lub cim ntawm cov lej sau se cuam tshuam nrog tus kws kho mob muaj ntawv tso cai, tus kws saib xyuas neeg mob muaj ntawv tso cai, thiab cov kws kho mob puas siab puas ntsws muaj ntawv tso cai muaj npe hauv cov lus hauv qab no:
Hom Kev Ua Haujlwm | Taxonomy |
Tus kws kho mob ua haujlwm | 225X |
Daim Ntawv Tso Cai Ua Haujlwm Ua Haujlwm | 164 X or 164 W |
Daim ntawv tso cai Psychiatric Technician | 106S, 167G lossis 3747 |
Cov txheej txheem txheej txheem twg tuaj yeem tsim nyog tau txais kev pabcuam tshiab ntxiv los ntawm SPA 23-0026 thov hauv Cov Kev Pabcuam Kev Mob Siab Tshwj Xeeb, DMC-ODS, thiab DMC cov txheej txheem xa khoom?
Cov lis dej num uas txhua hom neeg muab kev pabcuam tshiab tuaj yeem thov tau teev nyob rau hauv Daim Ntawv Txuas A ntawm SPA los ntawm kev xa khoom thiab hom neeg muab kev pabcuam.
Cov kev pabcuam uas muab los ntawm Cov Kws Kho Mob yuav raug them rov qab li cas?
Cov kev pabcuam uas muab los ntawm Cov Kws Khomob yuav raug them rov qab rau tib tus nqi raws li daim ntawv tso cai lossis sau npe cov kws kho mob nyob rau hauv Clinical Trainees txoj haujlwm. Yuav kom tau txais tus nqi tsim nyog rau lawv txoj haujlwm, Cov Kws Kho Mob yuav tsum siv cov kev sau se thiab kev hloov pauv ua ke uas tau teev tseg hauv cov lus hauv qab no:
Tsis muaj. | Txoj hauj lwm (s) Hom | Taxonomy | Hloov kho |
1. | Tub Kawm Ntawv Kho Mob hauv Clerkship | 1744 | Tsis muaj |
2. | LCSW, MFT lossis LPCC Clinical Trainee | 3902 | AJ |
3. | Psychologist Clinical Trainee | 3902 | AH |
4. | Registered Nurse Clinical Trainee | 3902 | TD |
5. | Cov Kws Kho Mob Kws Kho Mob Ua Haujlwm | 3902 | TE |
6. | Psychiatric Technician Clinical Trainee | 3902 | HM |
7. | Occupational Therapist Clinical Trainee | 3902 | CO |
8. | Nurse Practitioner/Clinical Nurse Specialist Clinical Trainee | 3902 | HP |
9. | Pharmacist Clinical Trainee | 3902 | HO |
10. | Tus kws kho mob Assistant Clinical Trainee | 3902 | Tsis muaj |
Cov nroog puas tuaj yeem txuas ntxiv CPT ® cov lej nrog HCPCS Code G2212 tom qab Lub Rau Hli 30, 2024?
G2212 tsis yog ib qho kev lees paub ntev kev pabcuam rau kev thov nrog cov hnub ua haujlwm tom qab Lub Rau Hli 30, 2024. Cov kab kev pabcuam xa mus rau G2212 nrog cov hnub ua haujlwm tom qab Lub Rau Hli 30, 2024 yuav raug tsis lees paub. CMS Internet Only Manual (IOM), Kev Tshaj Tawm 100-04, Medicare Claims Processing Manual, Tshooj 12, Tshooj 30.6.15 qhia meej tias G2212 yog tus lej txwv tsis pub tshaj uas tsuas yog siv tau nrog CPT® cov lej 99205 thiab 99215. Raws li cov lej no muaj lwm txoj hauv kev, Medicare-tau lees paub cov lej kev pabcuam ntev (G0316, 99415 thiab 99416), Short Doyle tsis lees paub G2212 rau kev thov nrog cov hnub ua haujlwm tom qab Lub Rau Hli 30, 2024. Hauv kev hloov ntawm G2212, cov nroog tuaj yeem txuas ntxiv Kev Ntsuas thiab Kev Tswj Xyuas (E&M) CPT® cov lej, tsis yog-E&M kev ntsuas CPT® cov lej, thiab tsis yog-E&M kho CPT® cov lej nrog lwm cov HCPCS lossis CPT® cov lej.
Thov nco ntsoov: Lub nroog tuaj yeem txuas ntxiv txuas ntxiv CPT® cov lej nrog G2212 rau kev thov nrog cov hnub ua haujlwm Lub Xya Hli 1, 2023 txog rau Lub Rau Hli 30, 2024.
Kev Ntsuas thiab Kev Tswj Xyuas (E&M) CPT ® cov lej yuav ua li cas, tsis yog-E&M kev ntsuas CPT ® cov lej, thiab cov lej uas tsis yog-E&M kho CPT ® cov lej yuav txuas ntxiv rau kev thov nrog cov hnub ua haujlwm tom qab Lub Rau Hli 30, 2024?
Cov lej kev pabcuam ncua ntev tau ntxiv rau Short Doyle uas tso cai txuas ntxiv ntawm kev soj ntsuam thiab kev tswj hwm (E&M) cov lej pabcuam uas yav dhau los txuas ntxiv nrog G2212. Rau qhov tsis yog-E&M kev ntsuam xyuas thiab cov kev pabcuam khomob, cov nroog tuaj yeem siv cov lej hloov pauv thaum cov kev pabcuam dhau mus dhau lub sijhawm tshwj xeeb uas tau teev tseg hauv Daim Ntawv Pabcuam. Lub nroog tuaj yeem thov tau (Lub ntsiab lus ua haujlwm: Kev hloov kho, 15 feeb) hloov tsis yog-E&M therapy CPT® code thaum lub sijhawm ua haujlwm tshaj li lub sijhawm teev tseg los ntawm CPT® code. Lub nroog tuaj yeem thov T2024 (Lub ntsiab lus ua haujlwm: Kev ntsuas hloov pauv, 15 feeb) es tsis yog E&M kev ntsuas CPT® code thaum lub sijhawm ua haujlwm tshaj li lub sijhawm teev tseg los ntawm CPT® code. Txhua qhov xwm txheej no tau piav qhia ntau ntxiv hauv qab no.
Dab tsi yog Kev Ntsuas thiab Kev Tswj Xyuas Cov Cai (E&M) cov kev pabcuam uas yuav tsis tuaj yeem txuas ntxiv nrog G2212 rau kev thov nrog cov hnub ua haujlwm tom qab Lub Rau Hli 30, 2024?
E&M cov lis dej num hauv qab no tsis tuaj yeem txuas ntxiv rau kev thov nrog cov hnub ua haujlwm tom qab Lub Rau Hli 30, 2024. Thov xa mus rau Lub Rooj Pabcuam (pom nyob rau ntawm MedCCC Lub Tsev Qiv Ntawv) rau cov ntsiab lus luv luv thiab cov lus qhia ntxiv ntawm cov lej tshwj xeeb.
SMHS E&M Codes | DMC/DMC-ODS E&M Codes |
99205, 99215, 99223, 99233, 99245, 99255, 99236, 99306, 99310, 99345, 99350 | 99205,99215,99236,99306,99310,99345,99350 |
Dab tsi yog cov kev pabcuam ncua sij hawm tshiab uas yuav siv los txuas ntxiv E&M cov lej teev saum toj no rau kev thov nrog cov hnub ua haujlwm tom qab Lub Rau Hli 30, 2024?
Cov lej pabcuam txuas ntxiv hauv qab no tau ntxiv rau Short Doyle.
Ntev Code | Kev xa khoom mus rau qhov Code tau ntxiv | Ntev Code txhais los ntawm 2024 American Medical Association Code Phau Ntawv |
G0316 | SMHS, DMC, DMC-ODS | Cov neeg mob nyob hauv tsev kho mob ntev lossis kev soj ntsuam saib xyuas kev soj ntsuam thiab kev tswj hwm kev pabcuam tshaj li lub sijhawm tag nrho rau cov kev pabcuam thawj zaug (thaum qhov kev pabcuam thawj zaug tau raug xaiv siv sijhawm nyob rau hnub uas thawj pabcuam); txhua 15 feeb ntxiv los ntawm tus kws kho mob lossis tus kws kho mob uas tsim nyog, nrog lossis tsis muaj kev sib cuag ncaj qha rau tus neeg mob. |
99415 | SMHS, DMC, DMC-ODS | Cov neeg ua haujlwm kho mob ntev ntev (qhov kev pabcuam tshaj li lub sijhawm siab tshaj plaws ntawm lub sijhawm tag nrho ntawm kev pabcuam) thaum lub sijhawm kev tshuaj xyuas thiab kev tswj xyuas kev pabcuam hauv chaw ua haujlwm lossis chaw khomob sab nraud, kev sib cuag ncaj qha nrog tus kws kho mob saib xyuas; thawj teev. |
99416 | SMHS, DMC, DMC-ODS | Cov neeg ua haujlwm kho mob ntev ntev (qhov kev pabcuam tshaj li lub sijhawm siab tshaj plaws nyob rau hauv thaj tsam ntawm tag nrho lub sijhawm ntawm kev pabcuam) thaum lub sijhawm kev tshuaj xyuas thiab kev tswj xyuas kev pabcuam hauv chaw ua haujlwm lossis chaw khomob sab nraud, kev sib cuag ncaj qha rau tus neeg mob nrog tus kws kho mob saib xyuas; txhua 30 feeb ntxiv. |
99417 | SMHS, DMC- ODS | Kev ntsuam xyuas tus neeg mob mus ntev thiab kev tswj xyuas cov sij hawm nrog lossis tsis muaj kev sib cuag nrog tus neeg mob ncaj qha dhau lub sij hawm xav tau ntawm qhov kev pabcuam thawj zaug thaum cov kev pabcuam thawj zaug tau raug xaiv siv sijhawm tag nrho, txhua 15 feeb ntawm tag nrho lub sijhawm. |
99418 | SMHS, DMC- ODS | Lub sijhawm ntev ntawm tus neeg mob hauv tsev kho mob lossis kev soj ntsuam kev soj ntsuam thiab kev tswj xyuas lub sijhawm nrog lossis tsis muaj kev sib cuag tus neeg mob ncaj qha dhau lub sijhawm xav tau ntawm cov kev pabcuam thawj zaug thaum cov kev pabcuam thawj tau raug xaiv siv sijhawm tag nrho, txhua 15 feeb ntawm tag nrho lub sijhawm. |
E&M cov lis dej num twg tuaj yeem txuas ntxiv lossis siv nrog cov kev pabcuam ncua ntev?
Cov lus hauv qab no teev tag nrho E&M cov lej uas tuaj yeem txuas ntxiv lossis siv nrog txhua qhov kev pabcuam ntev. Kom ua tiav cov lus piav qhia, thov xa mus rau Lub Rooj Pabcuam (nyob hauv MedCCC Library).
Ntev Code | SMHS Cov Txheej Txheem Txheej Txheem uas yuav siv tau nrog Txoj Cai Ntev Ntev no | DMC/DMC-ODS Cov Txheej Txheem Txheej Txheem Uas Yuav Siv Tau Nrog Txoj Cai Ntev Ntev |
G0316 | 99223, 99233, 99236 | 99236 |
99415 | 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215 | 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215 |
99416 | 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99415 | 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215 |
99417 | 99245, 99345, 99350 | (DMC-ODS) 99345, 99350 |
99418 | 99255, 99306, 99310 | (DMC-ODS) 99306, 99310 |
Thov nco ntsoov tias CPT® tus lej 99202 tuaj yeem tshaj tawm nrog 99415 yog tias 99415 siv los tshaj tawm cov kev pabcuam sib txawv ntawm 99202. Thov xa mus rau NCCI phau ntawv qhia kom paub meej txog qhov ua tau zoo sib xws tab sis muaj kev sib txawv txaus.
Ntev npaum li cas cov kev pabcuam raug siv?
E&M cov lis dej num tau teev tseg saum toj no tuaj yeem siv nrog cov kev pabcuam ntev raws li cov cai cuam tshuam nrog txhua qhov kev pabcuam ntev. Txhua tus neeg muab kev pabcuam uas tuaj yeem muab tus lej txheej txheem tseem ceeb yog tsim nyog los muab cov lej pabcuam ntev. Rau ib daim ntawv teev tag nrho ntawm cov neeg muab kev pabcuam tsim nyog thiab cov piv txwv ntawm kev siv txhua qhov kev pabcuam ntev npaum li cas, thov mus rau ntawm Lub Rooj Pabcuam (nyob hauv MedCCC Library).
Ntev Code
| Sijhawm koom nrog Code | General Claiming Rules for Code |
G0316 | 15 feeb | Txoj cai no ua raws li txoj cai nruab nrab (xws li midpoint thiab ntxiv 1 feeb). Yog li ntawd, 8 feeb yuav tsum tau ntsib los yog tshaj ua ntej 1 units ntawm no code yuav tsum tau thov. |
99415 | 60 feeb | Txoj cai no siv qhov tseeb nruab nrab. 30 feeb yuav tsum tau ntsib los yog tshaj ua ntej 1 units ntawm no code yuav tsum tau thov. |
99416 | 30 feeb | Txoj cai no siv qhov tseeb nruab nrab. Cov lej no yog tus lej ntxiv rau 99415 rau txhua qhov ntxiv 30 feeb dhau 99415. 15 feeb yuav tsum tau ntsib los yog tshaj ua ntej 1 units ntawm no code yuav tsum tau thov. |
99417 | 15 feeb | Cov cai no tau thov hauv tiaj tus 15 feeb increments. 15 feeb yuav tsum tau ntsib los yog tshaj ua ntej 1 units ntawm no code yuav tsum tau thov. |
99418 | 15 feeb | Cov cai no tau thov hauv tiaj tus 15 feeb increments. 15 feeb yuav tsum tau ntsib los yog tshaj ua ntej 1 units ntawm no code yuav tsum tau thov. |
99415 thiab 99416 puas tuaj yeem siv los txuas ntxiv sijhawm rau E&M cov lej uas tsis yog tus lej kawg hauv koob (99202, 99203, 99204, 99212, 99213, thiab 99214)?
Thaum CPT® cov lej 99415 thiab 99416 tau siv ua ke nrog 99202, 99203, 99204, 99212, 99213, thiab 99214, CPT® cov lej 99415 thiab 99416 tsis txuas sijhawm. CPT® tus lej 99415 thiab 99416 tab tom tshaj tawm cov kev pabcuam sib txawv uas tau muab rau tib hnub lossis ib txhij rau thawj qhov kev pabcuam. Piv txwv li, yog tias tus kws kho mob pom tus neeg mob thaum sawv ntxov rau 20 feeb thiab tus neeg mob rov qab los thaum tav su rau qhov sib txawv 30 feeb, tus kws kho mob tuaj yeem thov ib chav ntawm 99202 rau kev mus ntsib thaum sawv ntxov thiab ib chav ntawm 99415 rau kev mus ntsib yav tav su. Yog xav paub ntxiv txog kev siv 99415 thiab 99416, thov xa mus rau American Medical Association CPT ® codebook.
Puas yog cov ntaub ntawv xa mus nrog cov lej kev pabcuam ntev raug zam los ntawm Medicare Kev Sib Koom Tes ntawm Kev Pabcuam (COB)?
Cov kev pabcuam ntev ntev 99417 thiab 99418 raug zam los ntawm Medicare COB vim Medicare tsis them rov qab rau cov lej no. Txawm li cas los xij, Medicare COB yuav tsum tau tshaj tawm rau cov kev pabcuam ntev 99415, 99416, thiab G0316. Thaum 99417 siv los txuas ntxiv CPT® code, ob txoj cai yuav raug tshaj tawm rau Medicare. Txawm li cas los xij, Medicare yuav tsis them nyiaj rov qab rau lub nroog rau qhov kev pabcuam ntev ntev 99417 thiab 99418.
Puas yog cov ntaub ntawv xa mus nrog cov lej kev pabcuam ntev raug zam los ntawm Lwm Qhov Kev Pabcuam Kev Noj Qab Haus Huv?
Tsis yog. Medi-Cal yog tus them rau qhov kawg. Yog li ntawd, cov nroog yuav tsum tau them nyiaj rov qab rau cov kev pab cuam uas them los ntawm tus neeg txais kev pab lwm yam kev pab them nqi kho mob ua ntej thov cov nyiaj rov qab los ntawm Medi-Cal. Daim ntawv thov xa mus rau Short Doyle yuav tsum tshaj tawm cov nyiaj tau txais los ntawm tus neeg tau txais txiaj ntsig lwm qhov kev pab them nqi kho mob. Short Doyle them nyiaj rov qab rau lub nroog tus nqi teev nyob rau hauv Medi-Cal Cov Nqi Them Nqi Noj Qab Haus Huv Tus Nqi Them Nqi tsawg dua cov nyiaj tau txais los ntawm tus neeg txais txiaj ntsig lwm qhov kev pab them nqi kho mob.
Piv txwv li, Medicare tej zaum yuav them rau tus thawj, tab sis tsis ntev kev pab cuam code, xws li 99417 thiab 99418. Hauv qhov no, SD/MC tseem xav tias yuav pom cov nyiaj them los ntawm Medicare lossis tus neeg txais txiaj ntsig OHC tau tshaj tawm txog qhov kev thov.
Qhov twg tsis yog-kev soj ntsuam thiab kev tswj xyuas cov kev pabcuam kev sojntsuam yuav tsis txuas ntxiv nrog HCPCS code G2212 rau kev thov nrog cov hnub ua haujlwm tom qab Lub Rau Hli 30, 2024?
Cov kev ntsuas tsis-E&M cov lej teev npe hauv qab no yuav tsis txuas ntxiv nrog G2212 rau kev thov nrog cov hnub ua haujlwm tom qab Lub Rau Hli 30, 2024. Thov xa mus rau lub Rooj Pabcuam tsim nyog rau cov lus txhais thiab cov ntaub ntawv ntxiv ntawm cov lej tshwj xeeb nyob hauv MedCCC Library.
SMHS Tsis-E&M Kev Ntsuas Cov Cai | DMC/DMC-ODS Tsis-E&M Kev Ntsuas Cov Cai |
90791, 90792, 90885, 90865, 96105, 96110, 96125, 96127, 96146. | 90791, 90792, 90865, 90885 |
Yuav ua li cas cov nroog yuav txuas ntxiv cov kev ntsuam xyuas tsis-E&M cov cai rau kev thov nrog cov hnub ua haujlwm tom qab Lub Rau Hli 30, 2024?
Hloov pauv kev ntsuas tus lej T2024 tau ntxiv rau Short Doyle. Qhov no yog 15-feeb code. Ib chav tsev ntawm T2024 tuaj yeem thov rau lub sijhawm ua haujlwm dhau qhov nruab nrab (ntawm 8 feeb). Lub nroog tuaj yeem thov cov chav tsim nyog ntawm T2024 es tsis txhob CPT® code teev nyob rau hauv cov lus hauv qab no thaum lub sijhawm ua haujlwm tshaj lub sijhawm siab tshaj plaws uas tau tso cai los ntawm CPT® code. Lub sijhawm cuam tshuam nrog cov lej ntsuas tsis yog-E&M tau muab hauv qab no. Thov nco ntsoov tias qee lub sijhawm cov lej no tau hloov pauv hauv FY 2024-25 kom ua raws li Medicare. Cov kev hloov no tseem zoo ib yam rau FY 2025-2026.
Piv txwv li, Tus Kws Lij Choj Lij Choj thiab Tsev Neeg Kho Mob (LMFT) uas muab 68 feeb ntawm kev ntsuam xyuas kev puas siab puas ntsws rau Medi-Cal nkaus xwb tus neeg txais txiaj ntsig yuav thov tsib units ntawm T2024. Lawv yuav tsis thov 90791. Txawm li cas los xij, yog tias tus neeg siv khoom muaj Medicare thiab Medi-Cal, lub nroog yuav tsum xa daim ntawv thov rau ib chav tsev ntawm 90791 rau Medicare thiab daim ntawv thov rau tsib units ntawm T2024 rau Short Doyle. Yog xav paub ntxiv txog yuav ua li cas thov HCPCS code T2024, thov xa mus rau Lub Chaw Pabcuam (nyob hauv MedCCC Library).
Code | Lub Sijhawm Txuas Nrog Code hauv FY 2023-24 | Lub Sijhawm Txuas Nrog Code raws li FY 2024-25 | Lub Sijhawm Tshaj Tawm Tshaj Tawm rau CPT Code raws li FY 2024-25 |
90791 | 15 feeb | 60 feeb | 67 nqi |
90792 | 15 feeb | 60 feeb | 67 nqi |
90865 | 15 feeb | 90 nqi | 97 nqi |
90885 | 15 feeb | 60 feeb | 67 nqi |
96105 | 60 feeb | 60 feeb | 67 nqi |
96110 | 15 feeb | 60 feeb | 67 nqi |
96125 | 60 feeb | 60 feeb | 67 nqi |
96127 | 15 feeb | 60 feeb | 67 nqi |
96146 | 15 feeb | 60 feeb | 67 nqi |
Puas muaj tus lej tsawg kawg nkaus ntawm HCPCS code T2024, cov nroog yuav tsum tshaj tawm?
Yog lawm. Yam tsawg kawg ntawm tsib units ntawm T2024 yuav tsum tau tshaj tawm ntawm kab kev pabcuam. Cov kab kev pabcuam uas tsawg dua tsib units ntawm HCPCS code T2024 yuav raug tsis lees paub. T2024 tsuas yog yuav tsum tau thov yog tias lub sijhawm ua haujlwm tshaj li lub sijhawm cuam tshuam nrog kev ntsuas tsis yog E&M CPT® code. Yam tsawg kawg ntawm 68 feeb ntawm lub sijhawm ua haujlwm yuav tsum tau them nqi T2024.
Qhov twg tsis yog-kev soj ntsuam thiab kev tswj xyuas cov kev pabcuam kev kho mob yuav tsis txuas ntxiv nrog HCPCS code G2212 rau kev thov nrog cov hnub ua haujlwm tom qab Lub Rau Hli 30, 2024?
Cov kab lis kev cai uas tsis yog-E&M tau teev tseg hauv qab no yuav tsis txuas ntxiv nrog G2212 rau kev thov nrog cov hnub ua haujlwm tom qab Lub Rau Hli 30, 2024. Thov xa mus rau Lub Rooj Pabcuam (nyob hauv MedCCC Lub Tsev Qiv Ntawv) rau cov lus txhais thiab cov lus qhia ntxiv txog cov lej tshwj xeeb.
SMHS Non-E&M Therapy Codes | DMC/DMC-ODS Tsis-E&M Cov Cai Kho Mob |
90837,90838,90845,90847,90849,90853,90870,90880 | 90846, 90847, 90849 |
Yuav ua li cas cov nroog yuav txuas ntxiv cov kev pabcuam uas tsis yog-E&M rau kev thov nrog cov hnub ua haujlwm tom qab Lub Rau Hli 30, 2024?
Hloov kho tus lej T2021 tau ntxiv rau Short Doyle. Qhov no yog 15-feeb code. Ib chav tsev ntawm T2021 tuaj yeem thov rau lub sijhawm ua haujlwm dhau qhov nruab nrab (ntawm 8 feeb).
Cov nroog tuaj yeem thov cov chav tsim nyog ntawm T2021 es tsis txhob CPT® code teev nyob rau hauv cov lus hauv qab no thaum lub sijhawm ua haujlwm tshaj lub sijhawm siab tshaj plaws uas tau tso cai los ntawm CPT® code lawv hloov pauv. Lub sijhawm cuam tshuam nrog cov lej ntsuas tsis yog-E&M tau muab hauv qab no. Thov nco ntsoov tias qee lub sijhawm no tau hloov pauv hauv FY 2024-25 kom ua raws li Medicare. Cov kev hloov no tseem zoo ib yam rau FY 2025-2026.
Piv txwv li, yog tias nruab nrab ntawm 31 feeb mus rau 67 feeb ntawm kev kho mob hlwb tau muab, cov nroog yuav thov ib chav tsev ntawm 90832. Txawm li cas los xij, yog tias 68 feeb ntawm kev kho mob hlwb tau muab, cov nroog yuav thov 5 units ntawm T2021. Thov xa mus rau Lub Rooj Pabcuam hauv qab no kom pom cov piv txwv ntxiv.
Thov nco ntsoov tias rau CPT® cov lej uas yuav tsum tau tshaj tawm nrog E&M code, xws li 90838 (Psychotherapy, 60 feeb nrog tus neeg mob thaum ua tiav nrog kev ntsuam xyuas thiab kev tswj hwm kev pabcuam), tag nrho kev mus ntsib yog txiav txim siab ntev thaum E&M code txuas ntxiv siv ib qho ntawm cov kev pabcuam ntev ntev. Yog li ntawd, HCPCS T2021 tsis tuaj yeem siv los hloov CPT® code 90838. Yog tias kev mus ntsib dhau 60 feeb, 90838 tsis tuaj yeem ncua sijhawm; tsuas yog E&M code nws tau tshaj tawm nrog tuaj yeem ua kom ntev.
CPT ® Code | Lub Sijhawm Txuas Nrog Code hauv FY 23-24 | Lub Sijhawm Txuas Nrog Code raws li FY 24-25 | Lub Sijhawm Tshaj Tawm Tshaj Tawm rau CPT ® Code raws li FY 2024-25 |
90837 | 60 feeb | 60 feeb | 67 nqi |
90845 | 15 feeb | 45 feeb | 52 nqi |
90847 | 50 feeb | 50 feeb | 57 nqi |
90849 | 15 feeb | 84 nqi | 91 nqi |
90853 | 15 feeb | 50 feeb | 57 nqi |
90870 | 15 feeb | 20 feeb | 27 nqi |
90880 | 60 feeb | 60 feeb | 67 nqi |
Puas muaj tus lej tsawg kawg nkaus ntawm HCPCS code T2021, cov nroog yuav tsum tshaj tawm?
Tsis muaj. Tsis muaj tus lej tsawg kawg nkaus ntawm HCPCS T2021 uas cov nroog yuav tsum tau tshaj tawm vim muaj qhov txawv txav ntawm cov lej kho mob. Piv txwv li, Tus Kws Lij Choj Lij Choj thiab Tsev Neeg Therapy (LMFT) uas muab 68 feeb ntawm kev kho puas siab puas ntsws rau Medi-Cal nkaus xwb tus neeg txais txiaj ntsig yuav thov tsib units ntawm T2021. Lawv yuav tsis thov 90837. Txawm li cas los xij, yog tias tus neeg thov muaj Medicare thiab Medi-Cal, lub nroog ntawd yuav tsum xa daim ntawv thov rau ib chav tsev ntawm 90837 rau Medicare thiab ib daim ntawv thov rau tsib units ntawm T2021 rau SD/MC. Yog xav paub ntxiv txog yuav ua li cas thov HCPCS code T2021, thov xa mus rau Lub Chaw Pabcuam (nyob hauv MedCCC Library). Yog tias qhov kev pabcuam tsis dhau qhov nruab nrab, nws tsis tuaj yeem thov.
Puas yog cov ntawv thov xa nrog T2024 thiab T2021 raug zam los ntawm Medicare Kev Koom Tes ntawm Cov Nyiaj Pab (COB)?
Tsis yog. Medi-Cal yog tus them rau qhov chaw kawg. Yog li, cov kws kho mob yuav tsum tau thov cov nyiaj them rov qab rau cov kev pab cuam uas them los ntawm tus neeg txais txiaj ntsig lwm qhov kev pab them nqi kho mob, suav nrog Medicare, ua ntej thov cov nyiaj rov qab los ntawm Medi-Cal. Daim ntawv thov xa mus rau Medi-Cal yuav tsum tshaj tawm cov nyiaj tau txais los ntawm tus neeg tau txais txiaj ntsig lwm yam kev pab them nqi kho mob. Medi-Cal them rov qab rau lub nroog tus nqi Medi-Cal tsawg dua cov nyiaj tau txais los ntawm tus neeg tau txais txiaj ntsig lwm yam kev pab them nqi kho mob. Yog li ntawd, cov nroog ua haujlwm rau cov neeg tau txais txiaj ntsig uas tau txais kev pabcuam ob npaug los ntawm Medicare yuav tsum tau them nyiaj rov qab los ntawm Medicare siv tus lej CPT ® uas tsim nyog ua ntej xa daim ntawv thov nrog HCPCS codes T2024 lossis T2021 rau Short Doyle. Lub nroog yuav tsum tau them nyiaj rov qab los ntawm Medicare raws li Medicare cov cai. Piv txwv li, tus kws kho mob uas siv sijhawm 100 feeb los ua kom tiav qhov kev ntsuam xyuas kev puas siab puas ntsws yuav tsum xa daim ntawv thov rau Medicare siv CPT® code 90791. CPT® code 90791 yog 60-feeb code. Txij li 100 feeb dhau lub sijhawm rau CPT® 90791, lub nroog yuav tshaj tawm xya chav ntawm T2024 thaum xa daim ntawv thov rau Short Doyle. 90791 yuav tsum qhia rau Medicare. DHCS yuav them rov qab rau lub nroog rau xya units ntawm T2024 ntawm lub nroog tus nqi rau tus kws kho mob uas tau teev tseg hauv daim ntawv thov, tsawg dua Medicare COB tus nqi.
Puas yog cov ntawv thov xa nrog T2024 lossis T2021 raug zam los ntawm cov cai kaw?
Tsis yog. Thaum tshaj tawm T2024 lossis T2021 hloov qhov kev ntsuam xyuas lossis kev kho CPT ® code, cov cai kaw tseg ntawm CPT ® code raug hloov pauv yuav siv tau. Yog li, yog tias qhov kev ntsuam xyuas lossis kev kho CPT ® code tsis tuaj yeem qhia nrog lwm tus lej pabcuam, ces T2024 lossis T2021 yuav tsum tsis txhob tshaj tawm nrog cov lej ntawd. Thaum T2021 lossis T2024 hloov pauv rau CPT ® code uas yog ib feem ntawm kev sib xyaw ua ke dhau los, tsis txhob suav nrog kev hloov pauv tsis tau thaum xa daim ntawv thov rau SD / MC.
Tsis tas li ntawd, T2021 thiab T2024 tsis tuaj yeem tshaj tawm nrog cov lej uas lawv tuaj yeem hloov pauv. Rau T2021, cov lej no yog 90837, 90838, 90845, 90847, 90849, 90853, 90870, thiab 90880. Ib yam li ntawd, T2024 tsis tuaj yeem tshaj tawm nrog 90791, 90792, 90865, 90885, 96105, 96110, 96125, 96127, thiab 96146. Thov xa mus rau Lub Rooj Pabcuam (nyob hauv MedCCC Library) yog xav paub ntxiv.
Yuav ua li cas cov nqi rau cov kev pabcuam ncua ntev, T2024, thiab T2021 suav li cas?
Tus nqi rau cov lis dej num no tau teeb tsa siv tib tus nqi teeb tsa txoj hauv kev rau cov kev pabcuam tus neeg mob tam sim no. Rau ib daim ntawv teev npe ntawm txhua lub nroog tus nqi los ntawm tus txheej txheem txoj cai thiab hom kws kho mob tsim nyog los muab kev pabcuam, thov mus saib Medi-Cal Cov Nqi Them Nqi Noj Qab Haus Huv.
Kev Txhaj Tshuaj thiab Txhaj Tshuaj thiab Cov Cai Li Cas 96367, 96368, 96372, 96373, 96376, thiab 96377 tuaj yeem hloov nrog HCPCS T2021 lossis T2024 tom qab Lub Rau Hli 30, 2024?
Tsis muaj. Tom qab Lub Rau Hli 30, 2024, cov nroog tsis tuaj yeem ncua sijhawm txhaj tshuaj / infusion codes uas tsis muaj tus lej tshwj xeeb ntxiv rau. Yog hais tias lub nroog yuav tsum tau tshaj tawm cov kev pabcuam ntxiv uas tshwm sim ib txhij nrog kev txhaj tshuaj / infusion, lawv yuav tsum siv cov lej pabcuam uas piav qhia txog cov kev pabcuam no.
Puas yuav cov lus qhia txog kev siv HCPCS cov lej T2021 thiab T2024 puas suav nrog hauv phau ntawv them nqi?
Yog lawm. Cov ntaub ntawv no muaj nyob rau hauv "Yuav Ua Li Cas Xaiv Cov Cai Raws Li Lub Sijhawm" ntu ntawm phau ntawv sau nqi, nyob hauv MedCCC Library.