Table Two: Outpatient CPT / HCPCS Coding For the first two years (based on the regional carve-in/implementation schedule) plans are required to utilize the CPT / HCPCS codes in Table Two below. When available both CPT and HCPCS codes are provided to support services delivery via different practitioner types / accommodate scope of practice coding requirements. In addition to the CPT / HCPCS codes, all line level service coding for SUD services must also include the modifier. Note the program should code the HF “HF” modifier to allow for data collection, however plans should not deny claims for failure to include. Table Two Providers will enter the line level coding for SUD outpatient services including: CPT / – HCPCS codes; unit (if applicable); and, the HF modifier on each service line CPT HCPCS Codes CPT Code Codes HCPCS APG OASAS Service Category Description Description description Psychiatric Assessment with Counseling-30 E&M minutes Psychiatric Assessment with Counseling Brief Code Select E&M Code – 315 N/A (30 minute min) Plus from Range: 90833 99201-99205, 99211-99215 PLUS Add-on Code 90833 Psychiatric Assessment with Counseling-45-50 E&M minutes Psychiatric Assessment with Counseling Code Select E&M Code 316 N/A (45-50 minute min) Plus from Range: 90836 99201-99205, 99211-99215 PLUS Add-On Code 90836 Alcohol/Substance Alcohol/Substance Individual Therapy Brief 90832 Interview assessment and – 315 G0396 25 minute minimum (Individual Brief 25 brief intervention minutes minimum) Alcohol/Substance Alcohol/Substance 90834 Interview assessment and Individual Therapy Normative – 316 (Individual G0397 brief intervention 45 minute minimum Normative 45 minutes minimum) Family/Couple Alcohol/Substance Family/Collateral Therapy w/o patient 90846 Counseling (30 services family / 317 T1006 30 minute minimum minute minimum) couple counseling w/o patient 90853 Alcohol/Substance; 318 Group Therapy Alcohol &/or Drug H0005
Table Two: Outpatient CPT / HCPCS Coding For the first two years (based on the regional carve-in/implementation schedule) plans are required to utilize the CPT / HCPCS codes in Table Two below. When available both CPT and HCPCS codes are provided to support services delivery via different practitioner types / accommodate scope of practice coding requirements. In addition to the CPT / HCPCS codes, all line level service coding for SUD services must also include the “HF” modifier. Note the program should code the HF modifier to allow for data collection, however plans should not deny claims for failure to include. Table Two – Providers will enter the line level coding for SUD outpatient services including: CPT / HCPCS codes; unit (if applicable); and, the HF modifier on each service line APG OASAS Service Category Description CPT Codes CPT Code Description HCPCS Codes HCPCS description 315 Psychiatric Assessment with Counseling – Brief (30 minute min) E&M Code Plus 90833 Psychiatric Assessment with Counseling-30 minutes Select E&M Code from Range: 99201-99205, 99211-99215 PLUS Add-on Code 90833 N/A 316 Psychiatric Assessment with Counseling (45-50 minute min) E&M Code Plus 90836 Psychiatric Assessment with Counseling-45-50 minutes Select E&M Code from Range: 99201-99205, 99211-99215 PLUS Add-On Code 90836 N/A 315 Individual Therapy – Brief 25 minute minimum 90832 Alcohol/Substance Interview (Individual Brief 25 minutes minimum) G0396 Alcohol/Substance assessment and brief intervention 316 Individual Therapy – Normative 45 minute minimum 90834 Alcohol/Substance Interview (Individual Normative 45 minutes minimum) G0397 Alcohol/Substance assessment and brief intervention 317 Family/Collateral Therapy w/o patient 30 minute minimum 90846 Family/Couple Counseling (30 minute minimum) w/o patient T1006 Alcohol/Substance services family / couple counseling 318 Group Therapy 90853 Alcohol &/or Drug H0005 Alcohol/Substance;
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