Children’s Behavioral Health Day Treatment-BHP Level- UQ four patients *H2012 HN UQ TL Hourly served- Services in an early $14.65 $14.97 $14.94 Y intervention/individualized family service plan (ISFP) Children’s Behavioral Health Day Treatment-BHP Level- UQ four patients *H2012 HN UQ TM Hourly $14.65 $14.97 $14.94 Y served- Services in an individualized education program (IEP) Children’s Behavioral Health Day HO Hourly Treatment-Master’s Level $95.00 $97.07 $96.90 Y Maximum Maximum Maximum Allowance Allowance Allowance Procedure Code Modifier Modifier Unit Service Description per unit PA/UR per unit per unit effective through 8/1/18-6/30/19* 7/1/19* 7/31/18 Children’s Behavioral Health Day Treatment-Master’s Level - Services in an H2012 HO TL Hourly $95.00 $97.07 $96.90 Y early intervention/individualized family service plan (ISFP) Children’s Behavioral Health Day H2012 HO TM Hourly Treatment-Master’s Level- Services in an $95.00 $97.07 $96.90 Y individualized education program (IEP) Children’s Behavioral Health Day Treatment-Master’s UN two patients H2012 HO UN Hourly $47.50 $48.54 $48.45 Y served Children’s Behavioral Health Day Treatment-Master’s Level UN two patients served- Services in an early H2012 HO UN TL Hourly $47.50 $48.54 $48.45 Y intervention/individualized family service plan (ISFP) Children’s Behavioral Health Day Treatment-Master’s Level UN two HO UN TM Hourly $47.50 $48.54 $48.45 Y patients served- Services in an individualized education program (IEP)
*H2012 HN UQ TL Hourly Children’s Behavioral Health Day Treatment-BHP Level- UQ four patients served- Services in an early intervention/individualized family service plan (ISFP) $14.65 $14.97 $14.94 Y *H2012 HN UQ TM Hourly Children’s Behavioral Health Day Treatment-BHP Level- UQ four patients served- Services in an individualized education program (IEP) $14.65 $14.97 $14.94 Y HO Hourly Children’s Behavioral Health Day Treatment-Master’s Level $95.00 $97.07 $96.90 Y Procedure Code Modifier Modifier Unit Service Description Maximum Allowance per unit through 7/31/18 Maximum Allowance per unit 8/1/18-6/30/19* Maximum Allowance per unit effective 7/1/19* PA/UR H2012 HO TL Hourly Children’s Behavioral Health Day Treatment-Master’s Level - Services in an early intervention/individualized family service plan (ISFP) $95.00 $97.07 $96.90 Y H2012 HO TM Hourly Children’s Behavioral Health Day Treatment-Master’s Level- Services in an individualized education program (IEP) $95.00 $97.07 $96.90 Y H2012 HO UN Hourly Children’s Behavioral Health Day Treatment-Master’s UN two patients served $47.50 $48.54 $48.45 Y H2012 HO UN TL Hourly Children’s Behavioral Health Day Treatment-Master’s Level UN two patients served- Services in an early intervention/individualized family service plan (ISFP) $47.50 $48.54 $48.45 Y HO UN TM Hourly Children’s Behavioral Health Day Treatment-Master’s Level UN two patients served- Services in an individualized education program (IEP) $47.50 $48.54 $48.45 Y
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