CALIFORNIA CODE OF REGULATIONS - State of California

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Page 533 TITLE 9. DIVISION 1 — DEPARTMENT OF MENTAL HEALTH § 1840.304 (6) Psychiatric Nursing Facility Services, except as provided in subsection (b), (7) Crisis Stabilization, and (8) Psychiatric Health Facility Services. (b) Psychiatric Nursing Facility Services may be claimed for the same day as a psychiatric inpatient hospital services, if the beneficiary has exercised the bed hold option provided by Title 22, Section 72520, 73504, 76506, and 76709.1, subject to the limitations of Title 22, Section 51535.1. (c) When psychiatric inpatient services are provided in a Short–Doyle/Medi–Cal hospital, in addition to the services listed in (a), psychiatrist services, psychologist services, mental health services, and medication support services are included in the per diem rate and not separately reimbursable, except for the day of admission. NOTE: Authority cited: Section 14680, Welfare and Institutions Code. Reference: Section 5778, Welfare and Institutions Code. Article 3. Specialty Mental Health Services Other than Psychiatric Inpatient Hospital Services § 1840.302. Psychiatric Nursing Facility Services. FFP for psychiatric nursing facility services shall be claimed by the State Department of Health Services in the same manner as FFP is claimed for other Medi–Cal services billed to the fiscal intermediary. NOTE: Authority cited: Section 14680, Welfare and Institutions Code. Reference: Section 5778, Welfare and Institutions Code. § 1840.304. Crosswalk Between Service Functions and HCPCS Codes. (a) When a provider bills the MHP for psychiatrist, psychologist, or EPSDT Supplemental Speciality Mental Health Services using a CPT or other HCPCS code in column A, then the MHP shall claim FFP based on the service function in column B at the units of time listed in column C. The dollar amount claimed shall be in accordance with Section 1840.105. Column A Column B Column C 90843 Mental Health Services 30 minutes Individual Psychotherapy 90844 Mental Health Services 50 minutes Individual Psychotherapy Z0300 Mental Health Services 25 minutes Individual Psychotherapy 90853 Mental Health Services 15 minutes Group Psychotherapy 90862 Medication Support 15 minutes Pharmacological Management 90870 Medication Support 25 minutes Electro Convulsive Therapy 90871 Medication Support 25 minutes Electro Convulsive Therapy Column A Column B Column C 90880 Mental Health Services 25 minutes Hypnotherapy 96100 Mental Health Services 60 minutes Psychological Testing 99201 Mental Health Services 20 minutes Office/OP Visit New Patient 99202 Mental Health Services 30 minutes Office/OP Visit New Patient 99203 Mental Health Services 40 minutes Office/OP Visit New Patient 99204 Mental Health Services 45 minutes Office/OP Visit New Patient 99205 Mental Health Services 60 minutes Office/OP Visit New Patient 99211 Mental Health Services 15 minutes Office/OP Visit Established Patient 99212 Mental Health Services 20 minutes Office/OP Visit Established Patient 99213 Mental Health Services 25 minutes Office/OP Visit Established Patient 99214 Mental Health Services 30 minutes Office/OP Visit Established Patient 99215 Mental Health Services 40 minutes Office/OP Visit Established Patient 99217 Mental Health Services 30 minutes Hospital Observation Care 99218 Mental Health Services 30 minutes Hospital Observation Care 99219 Mental Health Services 50 minutes Hospital Observation Care 99220 Mental Health Services 70 minutes Hospital Observation Care 99221 Medication Support 30 minutes Hospital Inpatient Initial Care 99222 Medication Support 50 minutes Hospital Inpatient Initial Care 99223 Medication Support 70 minutes Hospital Inpatient Initial Care
§ 1840.304 CALIFORNIA CODE OF REGULATIONS Page 534 Column A Column B Column C 99231 Medication Support 15 minutes Hospital Inpatient Subsequent Care 99232 Medication Support 25 minutes Hospital Inpatient Subsequent Care 99233 Medication Support 35 minutes Hospital Inpatient Subsequent Care 99238 Mental Health Services 30 minutes Hospital Discharge Services 99239 Mental Health Services 50 minutes Hospital Discharge Services 99241 Mental Health Services 25 minutes Office Consultation 99242 Mental Health Services 35 minutes Office Consultation 99243 Mental Health Services 45 minutes Office Consultation 99244 Mental Health Services 60 minutes Office Consultation 99245 Mental Health Services 80 minutes Office Consultation 99251 Mental Health Services 20 minutes Initial Inpatient Consultation 99252 Mental Health Services 40 minutes Initial Inpatient Consultation 99253 Mental Health Services 55 minutes Initial Inpatient Consultation 99254 Mental Health Services 80 minutes Initial Inpatient Consultation 99255 Mental Health Services 110 minutes Initial Inpatient Consultation 99261 Mental Health Services 10 minutes Follow Up Inpatient Consultation 99262 Mental Health Services 20 minutes Follow Up Inpatient Consultation 99263 Mental Health Services 30 minutes Follow Up Inpatient Consultation 99271 Mental Health Services 30 minutes Confirmatory Consultation 99272 Mental Health Services 45 minutes Confirmatory Consultation Column A Column B Column C 99273 Mental Health Services 45 minutes Confirmatory Consultation 99274 Mental Health Services 45 minutes Confirmatory Consultation 99275 Mental Health Services 45 minutes Confirmatory Consultation 99281 Mental Health Services 25 minutes Emergency Dep’t. 99282 Mental Health Services 30 minutes Emergency Dep’t. 99283 Crisis Intervention 30 minutes Emergency Dep’t. 99284 Crisis Intervention 45 minutes Emergency Dep’t. 99285 Crisis Intervention 60 minutes Emergency Dep’t. 99301 Medication Support 30 minutes Nursing Facility Assessment 99302 Medication Support 40 minutes Nursing Facility Assessment 99303 Medication Support 50 minutes Nursing Facility Assessment 99311 Medication Support 15 minutes Nursing Facility Subsequent Care 99312 Medication Support 25 minutes Nursing Facility Subsequent Care 99313 Medication Support 35 minutes Nursing Facility Subsequent Care 99321 Medication Support 30 minutes Domiciliary/Rest Home; New Patient; 99322 Medication Support 40 minutes Domiciliary/Rest Home; New Patient; 99323 Medication Support 50 minutes Domiciliary/Rest Home; New Patient; 99331 Medication Support 30 minutes Domiciliary/Rest Home; Established Patient 99332 Medication Support 40 minutes Domiciliary/Rest Home; Established Patient 99333 Medication Support 50 minutes Domiciliary/Rest Home; Established Patient
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CALIFORNIA CODE OF REGULATIONS - State of California

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