Individual Counseling - 86C $95.93 $134.11 Individual Home Based Counseling - Individual - $134.11 88K Family Counseling - 86F $79.93 $111.75 Family Home Based Counseling - Family - 88K $111.75 Group Group Counseling - 86E $23.52 $32.88 Court Testimony - 86H $91.19 Court Related Services Deposition - 86H $91.19 Mediation 86H $91.19 – Diagnostic Consultation Diagnostic Consultation - 81H $65.22 $91.19 Translator/Interpreter Cost Reimbursement-Requires Contract Service Code 98L Services Manager prior authorization Additional reimbursement for services provided in CPS DESIGNATED UNDERSERVED AREAS: Missed Appointments: Refer to Section 2.13.1 Travel to Underserved County: Refer to Section 2.13.3 fORM Q - Attachment A-2 C –table FEE SCHEDULE EVALUATION AND TREATMENT SERVICES – Payment is based on of service." The allowable unit rate for the type of service delivered is the “unit rate consistent with the highest credential held by the service provider. LCSW, LMFT, LPC & LSOTP Psychosocial Assessment & Counseling – Location & Unit Rate Category Service - Service Code In Office Home Based Out of Office Psychosocial Psychosocial Assessment 86U $67.15 $93.88 $93.88 –
Individual Individual Counseling - 86C $95.93 $134.11 Home Based Counseling - Individual - 88K $134.11 Family Family Counseling - 86F $79.93 $111.75 Home Based Counseling - Family - 88K $111.75 Group Group Counseling - 86E $23.52 $32.88 Court Related Services Court Testimony - 86H $91.19 Deposition - 86H $91.19 Mediation – 86H $91.19 Diagnostic Consultation Diagnostic Consultation - 81H $65.22 $91.19 Translator/Interpreter Services Service Code 98L Cost Reimbursement-Requires Contract Manager prior authorization Additional reimbursement for services provided in CPS DESIGNATED UNDERSERVED AREAS: Missed Appointments: Refer to Section 2.13.1 Travel to Underserved County: Refer to Section 2.13.3 fORM Q - Attachment A-2 –table C FEE SCHEDULE – EVALUATION AND TREATMENT SERVICES Payment is based on “unit of service." The allowable unit rate for the type of service delivered is the rate consistent with the highest credential held by the service provider. LCSW, LMFT, LPC & LSOTP – Psychosocial Assessment & Counseling Category Service - Service Code Location & Unit Rate In Office Home Based Out of Office Psychosocial Psychosocial Assessment – 86U $67.15 $93.88 $93.88
Application-Additional-Documents.docx