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.
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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​​ 

Lub Sijhawm Tshaj Tawm Dhau Txoj Cai Txheej Txheem Tseem Ceeb rau Cov Kev Thov nrog Hnub Ua Haujlwm tom qab Lub Rau Hli 30, 2024 (Ntu ntxiv rau 6/18/2024)​​ 

Kev Ntsuam Xyuas thiab Kev Tswj Xyuas (E&M).​​ 

Tsis-E&M Kev Ntsuas Kev Ntsuas​​ 

Non-E&M Therapy Services​​ 

Kev Pabcuam Kev Tswj Xyuas thiab Kev Siv Tshuaj Xyuas / Kev Pov Hwm Zoo (UR / QA)​​ 

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 tswjfwm thiab UR/QA tsis tau hloov pauv raws li Kev Hloov Kho Kev Them Nyiaj thiab yuav tseem nyob hauv qab cov txheej txheem Certified Public Expenditure (CPE) tam sim no. Txhua peb lub hlis thiab txhua xyoo, cov nroog yuav xa cov ntawv thov rau kev tswj hwm thiab UR/QA cov kev pabcuam uas yuav raug sib phim nrog tus nqi. Txawm hais tias cov txheej txheem no yuav tseem sib haum xeeb nrog tus nqi, DHCS tau cog lus tias yuav txhim kho qhov ua tau zoo ntawm cov txheej txheem no kom txo tau lub nra hnyav ntawm kev tswj hwm rau cov nroog. DHCS tau tshaj tawm BHIN 23-049 Kev Tswj Xyuas thiab Kev Siv Tshuaj Xyuas/Kev Lees Paub Zoo (UR/QA) Kev Them Nyiaj Rov Qab Raws Li Kev Hloov Kho Kev Them Nyiaj thiab yuav tshaj tawm cov lus qhia ntxiv txog qhov teeb meem 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, cov nroog yuav tsum xa daim ntawv them nqi kawg uas qhia txog cov nqi tiag tiag thaum Lub Kaum Ob Hlis 31st tom qab kaw lub xyoo nyiaj txiag. Daim ntawv them nqi kawg yuav raug tshuaj xyuas. Thov saib BHIN 23-049 kom 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.​​ 

Mob Psychiatric Inpatient Rates​​ 

Vim li cas cov nqi kho mob tsis suav nrog rau hauv tus nqi pw hauv tsev 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 kho mob tshaj lij raug them rov qab raws li daim ntawv teev nqi rau cov kev pabcuam kho mob sab nraud. Qhov no yog qhov yuav tsum tau ua ntawm CMS hauv kev pom zoo ntawm DHCS State Plan Amendment 23-015, tsis yog DHCS txoj cai. Cov nroog yuav tau txais nyiaj rau cov kev pabcuam tshaj lij 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.​​ 

Qhov Kev Pabcuam Kev Kho Tshuaj Ntxov (NTP) Tus Nqi​​ 

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 tias cov chaw muab kev pab tej zaum yuav tau thov cov kev pab cuam Narcotic Treatment Program (NTP) rau ib tus tswv cuab Medi-Cal tib hnub uas lwm cov kev pab cuam Drug Medi-Cal Organized Delivery System (DMC-ODS), tshwj xeeb yog kev kho mob hauv tsev, tsis kam lees. Raws li tau piav qhia hauv MHSUD IN 17-039, thaum ib tug tswv cuab xav tau Tshuaj Kho Mob Rau Kev Quav Yeeb Tshuaj (MAT) ua ib feem ntawm lawv txoj kev npaj kho mob, cov kev pabcuam NTP (suav nrog kev noj tshuaj methadone, kev sab laj ib leeg, thiab kev sab laj pab pawg) yuav tau them rov qab rau tib hnub li lwm yam kev pabcuam DMC-ODS kom ntseeg tau tias them nyiaj rau txhua tus neeg muab kev pabcuam. DHCS tau hloov kho lub tshuab them nqi kom cov nroog tuaj yeem xa cov ntawv thov rau cov kev pabcuam NTP rau tib hnub nrog lwm cov kev pabcuam DMC-ODS hauv lub tshuab them nqi Short-Doyle Medi-Cal yam tsis raug kaw. Cov kev hloov kho tshiab rau lub kaw lus them nqi tau siv rov qab. Cov Rooj Pabcuam, uas tuaj yeem pom ntawm MedCCC Library, kuj tau hloov kho tshiab lawm.​​ 

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 tus nqi ntawm NTP xws li kev kuaj lub cev, cov kws kho mob thiab cov nroog tsis tuaj yeem them cov nqi sib cais thiab sib nrug ntawm tus nqi sib koom ua ke. Cov nqi NTP tuaj yeem pom ntawm no.​​ 

Kev Siv Tshuaj Tsis Zoo (SUD) Cov Nqi Nyob Nyob​​ 

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.​​ 

Tham txog BHIN 23-068 & MedCCC Library uas muaj SMHS, DMC, thiab DMC-ODS phau ntawv them 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.​​ 

Mobile Crisis Rates​​ 

Dab tsi hloov pauv tau siv los txhim kho tus nqi ntsib? (Hloov kho 6/10/25)​​ 

DHCS tau siv ob qho tib si Crisis Resource Need Calculator uas tau tsim los ntawm National Association of State Mental Health Directors (NASMHPD) thiab daim ntawv qhia DHCS uas muaj npe hu ua "Assessing the Continuum of Care for Behavioral Health Services in California" los tsim cov nqi ntsib Mobile Crisis.​​ 

Cov kev hloov pauv uas tau xav txog hauv kev xam tus nqi suav nrog: tus lej kwv yees ntawm cov pab pawg Mobile Crisis uas xav tau raws li Crisis Resource Need Calculator, lub sijhawm mus ncig kwv yees, tus lej kwv yees ntawm kev ntsib, tus nqi them ib teev rau cov pab pawg Mobile Crisis hauv nroog thiab tus nqi nruab nrab ntawm cov pab pawg Mobile Crisis hauv nroog - ob qho tib si los ntawm FY 2023/24 MH/DMC Outpatient County Rate, lub sijhawm pabcuam ncaj qha, kev saib xyuas thiab lub sijhawm tos. Rau cov Xyoo Nyiaj Txiag tom ntej no, DHCS hloov kho cov nqi ntsib teeb meem ntawm xov tooj ntawm tes txhua xyoo siv Center for Medicare thiab Medicaid Services (CMS) Home Health Agency Market Basket Index los suav nrog kev nce nqi.​​ 

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.
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Li cas mileage thiab tsheb thauj mus los suav rau?​​ 

Lub sijhawm thiab kev thauj mus los rau pab pawg neeg thaum muaj teeb meem mobile yog suav nrog rau hauv tus nqi ntawm kev kub ntxhov mobile. Rau kev ntsib teeb meem thaum muaj xwm txheej ceev, qhov mais yuav raug them thaum pab pawg Mobile Crisis npaj kom thauj tus neeg mob mus rau qib siab dua siv HCPCS tus lej A0140 (Kev Thauj Mus Los, mais). Lub sijhawm uas siv rau kev thauj mus los thiab kev xa khoom sov so no tuaj yeem them raws li HCPCS code T2007 (Kev Thauj Mus Los, lub sijhawm tos).​​ 

Xav paub ntau ntxiv ntawm cov lej sau nqi ntsig txog Mobile Crisis tuaj yeem pom hauv MedCCC Library.

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Puas yuav tus nqi rau EMT thiab cov kws kho mob yuav muab ntxiv rau tus nqi tam sim no?​​ 

Tsis yog, tus nqi tam sim no rau HCPCS codes kev thauj mus los mais (A0140) thiab lub sijhawm tos kev thauj mus los (T2007) tsis yog raws li hom kev muab kev pabcuam. Rau cov lej no, muaj ib tus nqi rau ib lub nroog thiab txhua hom neeg muab kev pabcuam uas yog ib feem ntawm pab pawg neeg pabcuam thaum muaj teeb meem ntawm tes siv tau cov lej no.​​ 

General Rate Information​​ 

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 xyoo muaj cai tau txais txhua yam kev pabcuam kho mob uas tsim nyog raws li 42 USC § 1396d (a) txawm tias cov kev pabcuam puas nyob hauv lub xeev Medicaid Plan, suav nrog txhua yam kev pabcuam DMC-ODS, txawm tias lawv nyob hauv lub nroog DMC." Yog li ntawd, cov nroog DMC-State Plan muaj lub luag haujlwm los muab cov kev pabcuam DMC-ODS rau cov neeg tau txais txiaj ntsig EPSDT (piv txwv li, cov neeg tau txais txiaj ntsig hnub nyoog qis dua 21 xyoo uas tau sau npe rau hauv cov cai pabcuam puv ntoob).​​ 

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​​ 

General Billing & Coding​​ 

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?​​ 

Cov ntawv qhia txog CPT ntawm American Medical Association (AMA) muab cov lus piav qhia ntxiv txog cov cai CPT thiab cov cai tswjfwm kev siv thiab kev xaiv cov cai. Phau ntawv CPT codebook yuav pab teb cov lus nug xws li: cov kev pabcuam twg uas ib tus lej suav nrog, yuav xaiv ib chav ntawm ib tus lej tshwj xeeb li cas thiab cov chaw muab kev pabcuam twg tuaj yeem thov rau ib qho kev pabcuam tshwj xeeb.​​ 

Ib lo lus nug uas DHCS tau txais feem ntau yog thaum twg yuav tsum tau thov ib chav sijhawm rau ib tus lej tshwj xeeb. Phau ntawv qhia txog tus lej CPT xyoo 2024 hais tias: "Cov lej teev CPT muaj ntau tus lej nrog lub sijhawm xaiv." Cov qauv hauv qab no yuav siv rau kev ntsuas lub sijhawm, tshwj tsis yog tias muaj cov lus qhia tshwj xeeb ntawm cov lej lossis cov lej hauv cov lus qhia, cov lus qhia hauv kab, lossis cov lus piav qhia ntawm cov lej rau qhov tsis sib xws. Ib chav sijhawm raug ua tiav thaum lub sijhawm nruab nrab dhau mus. Piv txwv li, ib teev tau tiav thaum 31 feeb dhau mus (ntau tshaj nruab nrab ntawm xoom thiab 60 feeb). Thaum tag nrho 91 feeb dhau mus, ces yuav muaj ib teev thib ob. Ib yam li ntawd, muaj kev nug txog seb cov kev pabcuam 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 nrog kev siv cawv." Nplooj ntawv 14 ntawm phau ntawv qhia txog CPT xyoo 2024 teev cov kev pabcuam uas suav nrog hauv txhua qhov kev ntsuam xyuas thiab kev tswj hwm thaum cov lej ntawd raug xaiv raws li lub sijhawm. "Kev txiav txim cov tshuaj, kev kuaj mob, lossis cov txheej txheem" yog ib qho ntawm cov kev pabcuam uas tau teev tseg.​​ 

Please note that DHCS’ rules may be more restrictive than the rules described in the CPT codebook. As a result, the CPT codebook should be used in conjunction with the billing manuals, located here.​​ 

Cov kws kho mob puas tuaj yeem sau nqi rau cov kev pabcuam thaum tus tswvcuab tsis nyob?​​ 

Yog tias tus lej kev pabcuam uas tau them nqi yog kev pabcuam uas tus tswv cuab tuaj yeem thov tau, lub sijhawm txhais tau tias lub sijhawm siv nrog tus tswv cuab rau lub hom phiaj ntawm kev muab kev kho mob. Yog tias cov cai uas tau them nqi teev cov haujlwm uas tsis yog kev saib xyuas ncaj qha rau cov tswv cuab tab sis yog rau qhov txiaj ntsig ntawm tus tswv cuab lossis cov neeg txhawb nqa ntawm tus tswv cuab, cov haujlwm ntawd raug tso cai, tsuav yog cov haujlwm tau ua uas yuav raug them nqi yog tias tus tswv cuab nyob ntawd. Piv txwv li, CPT code 99202 (chaw ua haujlwm lossis lwm qhov kev mus ntsib kws kho mob sab nraud) suav nrog "keeb kwm thiab / lossis kev kuaj mob uas tsim nyog" ua ib feem ntawm cov kev pabcuam piav qhia los ntawm cov cai. Raws li Cov Lus Qhia Txog Kev Ntsuam Xyuas thiab Kev Tswj Xyuas Kev Pabcuam hauv phau ntawv codebook xyoo 2024 CPT, qhov no txhais tau tias "pab neeg saib xyuas tuaj yeem sau cov ntaub ntawv, piv txwv li, los ntawm lub rooj vag kev noj qab haus huv hauv hluav taws xob lossis daim ntawv nug lus." Yog tias kev sib sau ua ke thiab kev sib sau ua ke cov ntaub ntawv kho mob uas yog ib feem ntawm cov ntaub ntawv kho mob ntawm tus tswv cuab los muab cov lus qhia rau kev kho mob lossis los ua kev kuaj mob, ces qhov kev ua ub no yuav suav tias yog lub sijhawm pabcuam thiab tuaj yeem thov tau txawm tias tus tswv cuab tsis nyob ntawd los xij. Yog tias tus lej kev pabcuam uas tau them nqi qhia txog kev pabcuam tswj cov ntaub ntawv lossis kev pabcuam sab laj rau tus tswv cuab, cov haujlwm ntawd raug tso cai. Hauv cov xwm txheej ntawd, lub sijhawm pabcuam uas thov tau yog lub sijhawm siv sab laj rau tus tswv cuab nrog tus(cov) kws tshwj xeeb thiab/lossis tus(cov) neeg txhawb nqa ntawm tus tswv cuab. Lub sijhawm pabcuam uas thov tau tsis suav nrog lub sijhawm mus ncig, cov haujlwm tswjfwm, kev tshuaj xyuas daim ntawv qhia, kev sau ntawv, kev tshuaj xyuas kev siv thiab kev ua haujlwm kom paub tseeb tias zoo lossis lwm yam haujlwm uas tus neeg muab kev pabcuam koom nrog uas twb suav nrog hauv tus nqi rau tus lej kev pabcuam lossis tau 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.​​ 

Kev cob qhia online (Nqe ntxiv 7/14/2025)​​ 

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.​​ 

Cov slides thiab cov ntaubntawv povthawj ntawm cov kev cob qhia hauv cov koob no tuaj yeem nkag mus tau los ntawm kev tsim ib tus account pub dawb ntawm: https://www.catalyst-center.org/learnupon. Siv lo lus "Payment Reform Series" hauv Catalog search function kom nrhiav tau cov kev cob qhia lossis tiv tauj Catalyst Center ntawm youth@catalyst-center.org kom paub ntxiv txog yuav ua li cas 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.​​ 
  

Kawm Tiav/Student Billing​​ 

Cov nroog yuav thov tau cov kev pabcuam kho mob los ntawm cov tub ntxhais kawm qib master thiab cov tub ntxhais kawm PhD uas tsis muaj daim ntawv tso cai ua haujlwm hauv kev xyaum ua haujlwm li cas? (Hloov kho tshiab rau hnub tim 6/10/25)​​ 

Hauv California, cov tub ntxhais kawm tiav qib master thiab cov tub ntxhais kawm PhD uas tsis muaj daim ntawv tso cai uas ua haujlwm hauv kev xyaum ua haujlwm yuav muab cov kev pabcuam kho mob hauv lawv qhov kev xyaum ua haujlwm raws li kev saib xyuas ntawm tus kws tshaj lij kev noj qab haus huv tus cwj pwm uas muaj daim ntawv tso cai. Cov Chaw Pabcuam Medicare & Medicaid (CMS) tau pom zoo rau California Txoj Cai Hloov Kho Txoj Kev Npaj Hauv 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 neeg muab kev pabcuam. Hnub siv tau ntawm SPA yog rov qab mus rau Lub Xya Hli 1, 2023.​​ 

DHCS tau hloov kho qhov kev thov nyiaj Short-Doyle Medi-Cal kom tso cai rau cov tub ntxhais kawm qib master thiab cov tub ntxhais kawm PhD uas tsis muaj daim ntawv tso cai uas ua haujlwm hauv kev xyaum ua haujlwm siv cov lej Common Procedural Terminology (CPT) kom tsim nyog los thov kom tau nyiaj rov qab thiab cov nqi them rau kev noj qab haus huv ntawm lub nroog rau cov tub ntxhais kawm uas ua haujlwm hauv kev xyaum ua haujlwm. Cov nroog tuaj yeem xa cov ntawv thov uas tau tuav rau cov tub ntxhais kawm lossis hloov cov ntawv thov uas tsis tau lees paub rau hnub ua haujlwm rau lossis tom qab Lub Xya Hli 1, 2023, raws li lub sijhawm txwv ntawm kev 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.​​ 

Kev pab txhais lus​​ 

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.​​ 

Cov Kev Pab Cuam Tshuam​​ 

Puas yog Medi-Cal them thiab them rov qab rau cov kev pabcuam uas tau muab rau tus neeg tau txais kev pabcuam thaum tus neeg tau txais kev pabcuam tsis nyob ntawd?​​ 

Yog, qee cov kev pabcuam Medicaid uas them suav nrog cov kev pabcuam uas muab rau tus neeg tau txais kev pabcuam thaum tus neeg tau txais kev pabcuam tsis nyob ntawd. Cov Lus Qhia Ntxiv 3 rau Daim Ntawv Ntxiv 3.1-A piav qhia txog Cov Kev Pabcuam Kev Noj Qab Haus Huv Lub Siab Tshwj Xeeb (SMHS), Cov Kev Pabcuam Kho Mob Txog Kev Siv Tshuaj Yeeb (DMC), thiab Cov Kev Pabcuam Kho Mob Txog Kev Siv Tshuaj Yeeb (DMC-ODS) uas muaj rau cov neeg tau txais txiaj ntsig Medicaid (Medi-Cal). Cov kev pabcuam no suav nrog kev sib cuag nrog cov neeg txhawb nqa tseem ceeb lossis lwm yam khoom siv uas koom nrog kev npaj thiab kev kho tus neeg tau txais txiaj ntsig. Yog tias qhov kev pabcuam uas tau them yuav tsum tau kom tus neeg txais txiaj ntsig nyob ntawd, ces kev sib cuag ua ke yuav tsum tshwm sim thaum tus neeg txais txiaj ntsig nyob ntawd. Yog tias qhov kev pabcuam uas tau them tsis tas yuav tsum tau tus neeg txais txiaj ntsig nyob ntawd, kev sib cuag ua ke yuav tshwm sim thaum tus neeg txais txiaj ntsig tsis nyob ntawd. Cov Phau Ntawv Qhia Txog Medi-Cal Luv Luv ntawm DHCS uas tau hloov kho tshiab nyob ntawm no. Cov lej cim uas cuam tshuam nrog cov hom kev pabcuam tshiab hauv SMHS Delivery System tuaj yeem pom ntawm no.
​​ 

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​​ 

Cov Kws Saib Xyuas Neeg Mob Uas Muaj Ntawv Tso Cai (LVNs) thiab Cov Kws Kho Mob Hlwb Uas Muaj Ntawv Tso Cai (LPTs) uas muaj kev kawm thiab daim ntawv pov thawj zoo, nyob rau hauv kev saib xyuas ntawm Tus Kws Saib Xyuas Neeg Mob lossis Kws Kho Mob, puas tuaj yeem muab cov tshuaj noj lossis txhaj rau cov neeg mob hauv lub cev Specialty Mental Health? (Hloov kho tshiab 9/10/24)​​ 

LVNs and LPTs are recognized provider types of SMHS within their scope of practice, as established in Supplement 3 to Attachment 3.1-A of California’s Medicaid State Plan.​​ 

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 Sijhawm Saib Xyuas Neeg Mob Tsis Ncaj Ncees​​ 

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?​​ 

Cov nroog tsuas yog yuav tsum xav txog lub sijhawm saib xyuas tus neeg mob ncaj qha, raws li tau txhais hauv phau ntawv qhia txog kev them nqi, thaum xaiv tus lej tsim nyog tshaj plaws los them nqi. Txawm li cas los xij, qhov no tsis tau txhais hais tias cov nroog yuav tsis tau txais nyiaj rov qab rau cov haujlwm xws li kev tshuaj xyuas daim ntawv qhia, kev sau ntawv, thiab lwm yam haujlwm cuam tshuam nrog kev npaj mus ntsib tus neeg mob lossis lub sijhawm tom qab kev pabcuam. Cov nqi uas DHCS them rau cov nroog tau hloov kho kom suav nrog tus nqi rau lub sijhawm ua haujlwm uas tsis siv rau kev saib xyuas tus neeg mob ncaj qha, uas suav nrog cov haujlwm uas tus neeg muab kev pabcuam koom nrog ua ntej thiab tom qab pom tus neeg mob, thiab "tsis tuaj koom".​​ 

Kev Pabcuam Ntau Pab Pawg​​ 

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 yuav nyuaj rau taug qab thaum tus neeg tau txais txiaj ntsig pom nyob rau hauv ntau pawg neeg sib tham tib hnub. Yog li ntawd, DHCS tau hloov kho qhov kev thov nyiaj Short-Doyle Medi-Cal kom tso cai rau cov nroog thov nyiaj rov qab rau ntau dua ib pawg kev pabcuam uas tau muab rau tib tus neeg tau txais txiaj ntsig los ntawm tib tus neeg muab kev pabcuam rau tib hnub. Cov nroog tuaj yeem thov ntau dua ib zaug rau tib tus neeg tau txais txiaj ntsig, tib hnub, rau kev pabcuam pab pawg .​​ 

Hom Kev Pabcuam Tshiab​​ 

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?​​ 

Ib tug Kws Kawm Txuj Ci Kho Mob yog ib tug neeg tsis muaj daim ntawv tso cai uas tau kawm hauv ib qho kev kawm tiav qib siab hauv Xeev California uas yuav tsum tau ua kom tus neeg ntawd tau txais daim ntawv tso cai ua Tus Kws Kho Mob Hlwb Muaj Ntawv Tso Cai lossis Tus Kws Kho Mob Uas Muaj Ntawv Tso Cai; tab tom koom nrog kev xyaum ua haujlwm, kev ua haujlwm sau ntawv, lossis kev xyaum ua haujlwm uas tus neeg ntawd tau pom zoo; thiab ua tau raws li txhua yam kev cai ntawm qhov kev kawm thiab/lossis pawg thawj coj saib xyuas kev tso cai kom koom nrog kev xyaum ua haujlwm, kev ua haujlwm sau ntawv lossis kev xyaum ua haujlwm thiab muab cov kev pabcuam kho mob hlwb lossis kev kho mob siv tshuaj yeeb, suav nrog, tab sis tsis txwv rau, txhua yam kev kawm thiab kev saib xyuas kev xyaum ua haujlwm.​​ 

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 rau kev siv cov txheej txheem taxonomy thiab cov txheej txheem hloov kho, tus thawj saib xyuas lub National Provider Identifier (NPI) kuj tseem yuav tsum tau ua rau txhua qhov kev thov rau cov kev pabcuam uas cov neeg xyaum kho mob muab.​​ 

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 cov kev pabcuam uas tus kws kho mob tau muab, tus thawj saib xyuas NPI yuav tsum tau tshaj tawm qhov twg?​​ 

Thaum thov cov kev pabcuam uas tus kws kho mob qhia, tus thawj saib xyuas daim ntawv NPI yuav tsum tau tshaj tawm ntawm theem thov (lub voj voog 2310D) thiab/lossis ntawm theem kab kev pabcuam (lub voj voog 2420D). Yog tias Tus Kws Qhia Kev Kho Mob muaj NPI, lawv kuj yuav tsum tshaj tawm nws. Cov ntsiab lus tshwj xeeb txog yuav ua li cas tshaj tawm cov neeg muab kev pabcuam NPIs ntawm 837P cov lus thov tau sau tseg rau hauv ASCX12 5010 Cov Lus Qhia Kev Siv uas muaj rau kev yuav khoom ntawm http://www.wpc-edi.com. Cov kev thov rau cov kev pabcuam uas cov kws kho mob cob qhia muab uas tsis tshaj tawm tus thawj saib xyuas NPI yuav raug tsis lees paub. Lub nroog yuav tsum xyuas kom meej tias tus kws kho mob uas saib xyuas Tus Neeg Kawm Txuj Ci Kev Kho Mob ua tau raws li qhov tsawg kawg nkaus uas tau piav qhia los ntawm pawg thawj coj saib xyuas kev tso cai.​​ 

Short Doyle yuav lees paub tus thawj saib xyuas NPI nrog cov ntaub ntawv hauv National Plan & Provider Enumeration System (NPPES). Cov kev thov rau Cov Neeg Kawm Txuj Ci Kho Mob uas tsis muaj tus thawj saib xyuas NPI raug cai yuav raug tsis lees paub nrog pawg kev hloov kho, tus lej laj thawj, thiab cov lus pom zoo 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?​​ 

Txawm hais tias hauv daim ntawv no hais li cas los xij, tus "tus saib xyuas" txhais tau tias tus kws kho mob uas tau txais daim ntawv tso cai kos npe rau cov ntawv sau txog kev nce qib. Tus kws kho mob uas tau txais daim ntawv tso cai kos npe rau cov ntawv sau txog kev nce qib lees txais lub luag haujlwm rau cov kev pabcuam uas tus kws cob qhia kho mob tau muab rau hnub ntawd, thiab tus neeg no tus NPI yuav tsum yog NPI uas tau tshaj tawm hauv lub voj voog 2310D thiab/lossis lub voj voog 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 pov thawj rau tus lej taxonomy rau Cov Neeg Pabcuam Kho Mob. Cov Kev Npaj Kho Mob Hlwb (MHP), cov nroog DMC-ODS, cov nroog DMC thiab cov neeg koom tes ua lag luam yuav tsum siv cov lej taxonomy uas tsib tus cim thawj zaug pib nrog 363AM rau Cov Neeg Pabcuam Kho Mob. Thov nco ntsoov tias txhua tus lej taxonomy pib nrog 363A qhov twg tus cim thib tsib tsis yog "M" yuav txuas ntxiv mus rau hom kws kho mob pabcuam 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 lej uas txhua hom neeg muab kev pabcuam tshiab tsim nyog tuaj yeem thov tau teev nyob rau hauv Daim Ntawv Txuas A ntawm SPA los ntawm lub kaw lus 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 cov kws kho mob tau muab yuav raug them rov qab rau tib tus nqi li cov kws kho mob uas tau tso cai lossis sau npe ua haujlwm hauv cov kws kho mob. Yuav kom tau txais tus nqi tsim nyog rau lawv txoj haujlwm, Cov Neeg Kawm Txuj Ci Kho Mob yuav tsum siv cov kev faib tawm thiab cov kev hloov kho ua ke teev nyob rau hauv lub rooj 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​​

Lub Sijhawm Tshaj Tawm Dhau Txoj Cai Txheej Txheem Tseem Ceeb rau Cov Kev Thov nrog Hnub Ua Haujlwm tom qab Lub Rau Hli 30, 2024 (Ntu ntxiv rau 6/18/2024)​​ 

Cov nroog puas tuaj yeem txuas ntxiv CPT ® cov lej nrog HCPCS Code G2212 tom qab Lub Rau Hli 30, 2024?​​ 

G2212 tsis yog tus lej kev pabcuam ntev uas txais tau rau cov kev thov uas muaj hnub pabcuam tom qab Lub Rau Hli 30, 2024 lawm. Cov kab kev pabcuam uas xa rau G2212 nrog hnub ua haujlwm tom qab Lub Rau Hli 30, 2024 yuav raug tsis lees paub. Phau Ntawv Qhia Txog Kev Siv Internet Xwb (IOM), Kev Tshaj Tawm 100-04, Phau Ntawv Qhia Txog Kev Ua Haujlwm ntawm Medicare, Tshooj 12, Ntu 30.6.15 piav qhia tias G2212 yog ib tus lej txwv heev uas tsuas yog siv tau nrog CPT® tus lej 99205 thiab 99215 xwb. Vim tias cov lej no muaj lwm txoj hauv kev, Medicare lees paub cov lej kev pabcuam ntev (G0316, 99415 thiab 99416), Short Doyle tsis lees paub G2212 rau cov kev thov nrog hnub ua haujlwm tom qab Lub Rau Hli 30, 2024. Hloov chaw ntawm G2212, cov nroog tuaj yeem nthuav dav Cov lej Kev Ntsuam Xyuas thiab Kev Tswj Xyuas (E&M) CPT® , cov lej kev ntsuam xyuas CPT® uas tsis yog E&M, thiab cov lej kev kho mob CPT® uas tsis yog E&M nrog lwm cov lej HCPCS lossis CPT® .​​ 

Thov nco ntsoov: Cov nroog yuav txuas ntxiv mus txuas ntxiv CPT® cov lej nrog G2212 rau cov kev thov nrog hnub ua haujlwm Lub Xya Hli 1, 2023 txog 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 ntev tshiab tau ntxiv rau Short Doyle uas tso cai rau kev txuas ntxiv ntawm kev ntsuam xyuas thiab kev tswj hwm (E&M) cov lej kev pabcuam uas yav dhau los tuaj yeem txuas ntxiv nrog G2212. Rau cov lej kev pabcuam ntsuam xyuas thiab kho mob uas tsis yog E&M, cov nroog tuaj yeem siv cov lej hloov pauv thaum qhov kev pabcuam dhau lub sijhawm teev tseg hauv Daim Ntawv Qhia Kev Pabcuam. Cov nroog tuaj yeem thov (Kev txhais lus ua haujlwm: Kev hloov kho mob, 15 feeb) hloov chaw kho mob uas tsis yog E&M CPT® code thaum lub sijhawm pabcuam tshaj lub sijhawm teev tseg los ntawm CPT® code. Cov nroog tuaj yeem thov T2024 (Kev txhais lus ua haujlwm: Kev hloov chaw ntsuam xyuas, 15 feeb) es tsis txhob siv tus lej ntsuas tsis yog E&M CPT® thaum lub sijhawm pabcuam tshaj lub sijhawm teev tseg los ntawm tus lej CPT® . Txhua qhov xwm txheej no tau piav qhia ntxiv hauv qab no.​​ 

Kev Ntsuam Xyuas thiab Kev Tswj Xyuas (E&M).​​ 

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?​​ 

Cov lej E&M uas teev hauv qab no tsis tuaj yeem txuas ntxiv rau cov kev thov nrog hnub ua haujlwm tom qab Lub Rau Hli 30, 2024. Thov saib Daim Ntawv Qhia Txog Kev Pabcuam (nyob rau hauv MedCCC Library) kom paub cov lus txhais luv luv thiab cov ntaub ntawv ntxiv txog 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​​	Kev pabcuam soj ntsuam thiab tswj kev saib xyuas neeg mob hauv tsev kho mob ntev lossis kev saib xyuas neeg mob dhau lub sijhawm tag nrho rau kev pabcuam thawj zaug (thaum xaiv kev pabcuam thawj zaug siv sijhawm rau hnub ntawm kev pabcuam thawj ); txhua 15 feeb ntxiv los ntawm tus kws kho mob lossis tus kws tshaj lij kev kho mob uas tsim nyog, nrog lossis tsis muaj kev sib cuag ncaj qha nrog 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?​​ 

Lub rooj hauv qab no teev tag nrho cov lej E&M uas tuaj yeem txuas ntxiv lossis siv nrog txhua tus lej kev pabcuam ntev. Yog xav paub cov lus piav qhia txog cov lej tag nrho, thov mus saib ntawm Rooj Pabcuam (nyob hauv Tsev Qiv Ntawv MedCCC).
​​ 

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® code 99202 yuav raug tshaj tawm nrog 99415 tsuav yog 99415 siv los tshaj tawm txog kev pabcuam sib cais, sib txawv ntawm 99202. Thov saib phau ntawv qhia NCCI kom paub meej ntxiv txog qhov kev pabcuam zoo sib xws tab sis txawv txaus.​​ 

Ntev npaum li cas cov kev pabcuam raug siv?​​ 

Cov lej E&M uas teev saum toj no yuav siv tau nrog cov lej kev pabcuam ntev raws li cov cai cuam tshuam nrog txhua tus lej kev pabcuam ntev. Txhua hom neeg muab kev pab uas tuaj yeem muab tus lej txheej txheem tseem ceeb tau tsim nyog los muab tus lej kev pabcuam ntev. Yog xav paub cov npe ntawm cov neeg muab kev pab uas tsim nyog thiab cov piv txwv txog kev siv txhua tus lej kev pabcuam ntev, thov saib ntawm Rooj Kev Pabcuam (nyob hauv MedCCC Tsev Qiv Ntawv).

​​ 

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.​​

Puas siv tau 99415 thiab 99416 los txuas lub sijhawm rau E&M cov lej uas tsis yog tus lej kawg hauv ib koob (99202, 99203, 99204, 99212, 99213, thiab 99214)?​​ 

Thaum CPT® cov lej 99415 thiab 99416 siv ua ke nrog 99202, 99203, 99204, 99212, 99213, thiab 99214, CPT® cov lej 99415 thiab 99416 tsis ncua lub sijhawm ntawm cov lej no. Cov lej CPT® 99415 thiab 99416 qhia txog kev pabcuam sib txawv uas tau muab rau tib hnub lossis tib lub sijhawm rau qhov kev pabcuam tseem ceeb. Piv txwv li, yog tias tus kws kho mob pom tus neeg mob thaum sawv ntxov li 20 feeb thiab tus neeg mob ntawd rov qab los thaum tav su rau 30 feeb sib txawv, 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 thaum tav su. Yog xav paub ntxiv txog kev siv 99415 thiab 99416, thov mus saib phau ntawv qhia txog American Medical Association CPT ® .​​ 

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 lej kev pabcuam ntev 99417 thiab 99418 raug zam los ntawm Medicare COB vim tias Medicare tsis them rov qab rau cov lej ntawd. Txawm li cas los xij, Medicare COB yuav tsum tau tshaj tawm rau cov lej kev pabcuam ntev 99415, 99416, thiab G0316. Thaum siv 99417 los txuas ntxiv CPT® code, ob qho tib si codes yuav raug tshaj tawm rau Medicare. Txawm li cas los xij, Medicare yuav tsis them rov qab rau cov nroog rau tus lej kev pabcuam 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 nqi kawg. Yog li ntawd, cov nroog yuav tsum thov kom them rov qab rau cov kev pabcuam uas tus neeg tau txais kev pab them nqi kho mob lwm yam ua ntej thov kom them rov qab los ntawm Medi-Cal. Daim ntawv thov uas xa mus rau Short Doyle yuav tsum tshaj tawm txhua qhov kev them nyiaj tau txais los ntawm tus neeg tau txais txiaj ntsig lwm yam kev pov hwm kho mob. Short Doyle them rov qab rau lub nroog tus nqi teev nyob rau hauv Medi-Cal Behavioral Health Fee Schedule rho tawm cov nyiaj them tau txais los ntawm tus neeg tau txais txiaj ntsig lwm yam kev pov hwm kho mob.​​ 

Piv txwv li, Medicare yuav them rau tus lej kev pabcuam tseem ceeb, tab sis tsis yog tus lej kev pabcuam ntev, xws li 99417 thiab 99418. Hauv qhov xwm txheej no, SD/MC tseem yuav xav kom pom cov nyiaj them los ntawm Medicare lossis tus neeg tau txais txiaj ntsig OHC tau tshaj tawm hauv daim ntawv thov.​​ 

Tsis-E&M Kev Ntsuas Kev Ntsuas​​ 

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 lej ntsuas uas tsis yog E&M teev hauv qab no yuav tsis raug txuas ntxiv nrog G2212 rau cov kev thov nrog hnub ua haujlwm tom qab Lub Rau Hli 30, 2024. Thov saib Daim Ntawv Qhia Kev Pabcuam kom tsim nyog rau cov lus txhais ntawm cov lej thiab cov ntaub ntawv ntxiv txog 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?​​ 

Tus lej ntsuas kev hloov pauv T2024 tau ntxiv rau Short Doyle. Qhov no yog ib qho code uas siv sijhawm 15 feeb. Ib chav ntawm T2024 tuaj yeem thov rau lub sijhawm pabcuam dhau qhov nruab nrab (ntawm 8 feeb). Cov nroog tuaj yeem thov cov chav tsev tsim nyog ntawm T2024 es tsis txhob siv tus lej CPT® teev nyob rau hauv lub rooj hauv qab no thaum lub sijhawm pabcuam tshaj lub sijhawm siab tshaj plaws uas tso cai los ntawm tus lej CPT® ntawd. Cov sijhawm cuam tshuam nrog cov lej ntsuas tsis yog E&M tau muab rau hauv qab no. Thov nco ntsoov tias qee lub sijhawm ntawm cov lej no tau hloov pauv hauv xyoo 2024-25 kom sib haum nrog Medicare. Cov kev hloov pauv no tseem zoo li qub rau xyoo 2025-2026.​​ 

Piv txwv li, tus Kws Kho Mob Kev Sib Yuav thiab Tsev Neeg uas Muaj Ntawv Tso Cai (LMFT) uas muab 68 feeb ntawm kev ntsuam xyuas kev puas siab puas ntsws rau tus neeg tau txais txiaj ntsig Medi-Cal xwb 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 ntawm 90791 rau Medicare thiab daim ntawv thov rau tsib chav ntawm T2024 rau Short Doyle. Yog xav paub ntxiv txog kev thov HCPCS code T2024, thov saib ntawm Rooj Pabcuam (nyob hauv MedCCC Library).

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Code​​	Lub Sijhawm Txuas Nrog Cov Cai hauv Xyoo 2023-24​​	Lub Sijhawm Txuas Nrog Cov Cai txij li xyoo 2024-25​​	Lub Sijhawm Siab Tshaj Plaws Rau CPT Code Txij Li Xyoo 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.​​ 

Non-E&M Therapy Services​​ 

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 lej kho mob uas tsis yog E&M uas teev hauv qab no yuav tsis raug txuas ntxiv nrog G2212 rau cov kev thov nrog hnub ua haujlwm tom qab Lub Rau Hli 30, 2024. Thov saib ntawm Rooj Kev Pabcuam (nyob hauv MedCCC Tsev Qiv Ntawv) rau cov lus txhais ntawm cov lej thiab cov ntaub ntawv ntxiv txog cov lej tshwj xeeb.

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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 tsev tsim nyog ntawm T2021 es tsis txhob siv tus lej CPT® teev nyob rau hauv lub rooj hauv qab no thaum lub sijhawm pabcuam tshaj lub sijhawm siab tshaj plaws uas tso cai los ntawm tus lej CPT® uas lawv hloov chaw. Cov sijhawm cuam tshuam nrog cov lej ntsuas tsis yog E&M tau muab rau hauv qab no. Thov nco ntsoov tias qee lub sijhawm no tau hloov pauv hauv xyoo 2024-25 kom sib haum nrog Medicare. Cov kev hloov pauv no tseem zoo li qub rau xyoo 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 cov lej CPT® uas yuav tsum tau tshaj tawm nrog tus lej E&M, xws li 90838 (Kev kho mob hlwb, 60 feeb nrog tus neeg mob thaum ua tiav nrog kev ntsuam xyuas thiab kev tswj hwm kev pabcuam), tag nrho qhov kev mus ntsib raug suav hais tias ntev dua thaum tus lej E&M raug ncua sijhawm siv ib qho ntawm cov lej kev pabcuam ntev dua saum toj no. Yog li ntawd, HCPCS T2021 tsis tuaj yeem siv los hloov CPT® tus lej 90838. Yog tias qhov kev mus ntsib dhau 60 feeb, 90838 tsis tuaj yeem ncua sijhawm; tsuas yog tus lej E&M uas nws tau tshaj tawm nrog thiaj li tuaj yeem ncua sijhawm.​​ 

CPT® Code​​	Lub Sijhawm Txuas Nrog Cov Cai hauv FY 23-24​​	Lub Sijhawm Txuas Nrog Cov Cai txij li xyoo FY 24-25​​	Lub Sijhawm Siab Tshaj Plaws Rau CPT® Code Txij Li Xyoo 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 yog. Tsis muaj tus lej tsawg kawg nkaus ntawm HCPCS T2021 uas cov nroog yuav tsum tshaj tawm vim muaj ntau yam kev hloov pauv ntawm cov lej kho mob. Piv txwv li, tus kws kho mob uas muaj daim ntawv tso cai rau kev sib yuav thiab tsev neeg (LMFT) uas muab 68 feeb ntawm kev kho mob hlwb rau tus neeg tau txais txiaj ntsig Medi-Cal xwb yuav thov tsib units ntawm T2021. Lawv yuav tsis thov 90837. Txawm li cas los xij, yog tias tus neeg siv khoom muaj Medicare thiab Medi-Cal, lub nroog ntawd yuav tsum xa daim ntawv thov rau ib chav ntawm 90837 rau Medicare thiab daim ntawv thov rau tsib chav ntawm T2021 rau SD/MC. Yog xav paub ntxiv txog kev thov HCPCS code T2021, thov mus saib ntawm Rooj Pabcuam (nyob hauv MedCCC Library). Yog tias ib qho kev pabcuam tsis dhau qhov nruab nrab, nws yuav tsis tuaj yeem thov tau.​​ 

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 nqi kawg. Yog li ntawd, cov neeg muab kev pab yuav tsum thov kom them rov qab rau cov kev pabcuam uas tus neeg tau txais kev pab them nqi kho mob lwm yam, suav nrog Medicare, ua ntej thov kom them rov qab los ntawm Medi-Cal. Daim ntawv thov uas xa mus rau Medi-Cal yuav tsum tshaj tawm txhua qhov nyiaj tau txais los ntawm tus neeg tau txais txiaj ntsig lwm yam kev pov hwm kho mob. Medi-Cal them rov qab rau lub nroog tus nqi Medi-Cal rho tawm cov nyiaj them los ntawm tus neeg tau txais txiaj ntsig lwm yam kev pov hwm kho mob. Yog li ntawd, cov nroog uas pab cov neeg tau txais txiaj ntsig uas tau txais kev pab los ntawm Medicare yuav tsum thov kom tau nyiaj rov qab los ntawm Medicare siv cov lej CPT ® ua ntej xa daim ntawv thov nrog HCPCS cov lej T2024 lossis T2021 rau Short Doyle. Lub nroog yuav tsum thov kom Medicare them rov qab 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. Vim tias 100 feeb dhau lub sijhawm rau CPT® 90791, lub nroog yuav tshaj tawm xya units ntawm T2024 thaum xa daim ntawv thov rau Short Doyle. Yuav tsum tau tshaj tawm 90791 rau Medicare. DHCS yuav them rov qab rau lub nroog rau xya units ntawm T2024 ntawm lub nroog tus nqi rau tus neeg muab kev pabcuam uas teev nyob rau hauv daim ntawv thov, rho tawm tus nqi Medicare COB.​​ 

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.​​ 

Ntxiv rau, T2021 thiab T2024 tsis tuaj yeem tshaj tawm nrog cov lej uas lawv tuaj yeem hloov pauv tau. 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 saib ntawm Rooj Pabcuam (nyob hauv Tsev Qiv Ntawv MedCCC) kom paub ntxiv.​​ 

Yuav ua li cas cov nqi rau cov kev pabcuam ncua ntev, T2024, thiab T2021 suav li cas?​​ 

Cov nqi rau cov lej no raug teeb tsa siv tib txoj kev teeb tsa tus nqi rau cov lej kev pabcuam neeg mob sab nraud tam sim no. Yog xav tau daim ntawv teev cov nqi ntawm txhua lub nroog los ntawm cov txheej txheem thiab hom chaw muab kev pabcuam uas tsim nyog los muab cov kev pabcuam, thov mus saib Medi-Cal Behavioral Health Fee Schedules.​​ 

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. Cov ntaub ntawv no suav nrog rau hauv ntu "Yuav Ua Li Cas Xaiv Cov lej Raws Li Lub Sijhawm" ntawm cov ntawv qhia them nqi, nyob hauv MedCCC Tsev Qiv Ntawv.
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