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April 20, 2015

Joint Communication Bulletin #133
Updated Billing Codes for Residential Treatment Services

The North Carolina Division of Medical Assistance issued Joint Communication Bulletin #133 ( referencing that as of May 3, 2015, codes that have been used for child residential services will be replaced by National HCPC codes. In reviewing the National HCPC codes, it is noted that some modifiers currently in use for the HCPC codes need to be updated. These changes will only impact Medicaid Child Residential Levels III and IV. There are no changes to the modifiers at this time for State/IPRS-funded services.


This change is effective May 3, 2015.  The change in modifiers will have an impact on submission of service authorization requests (SARs), authorizations and claims for Medicaid. Starting May 3, 2015 and forward, all Medicaid authorizations and claims will need to reflect the new modifiers.


Partners Utilization Management (UM) Department will make the following corrections for Medicaid authorizations currently in AlphaMCS with an end date beyond May 2, 2015:

  • UM will end date all current authorizations for May 2, 2015 and enter a new SAR with the beginning date of May 3, 2015. The end date for those SARs will be the last date of any current authorization in the system.
    (For example: Provider has an existing authorization with an end date of May 15, 2015.  UM will end date the current authorization as of May 2, 2015 and the new SAR will start on May 3, 2015 with an end date of May 15, 2015.)
  • For any authorizations requests providers submit between now and May 3, 2015, please reflect the end date as May 2, 2015.  Providers will then need to submit the next Medicaid SAR prior to May 3, 2105 for ongoing authorization.
  • Medicaid SARs or claims submitted with old modifiers will not be processed for dates of service May 3, 2015 forward.

The changes are as follows for Medicaid only. There are no changes to IPRS.


CodeNew ModifierDescription
H0019HQLevel III, four beds or less
H0019TJLevel III, five or more beds
H0019HKLevel IV, four beds or less
H0019URLevel IV, five or more beds


As always, please direct questions to Partners Utilization Management Department at 704-842-6346.

About Partners Behavioral Health Management
Partners Behavioral Health Management (Partners BHM) provides local management of publicly-funded behavioral health services in Burke, Catawba, Cleveland, Gaston, Lincoln, Iredell, Surry, and Yadkin counties. Offices are located in Elkin, Hickory, and Gastonia. Individuals in need of behavioral health services can call our Customer Service call center 24 hours a day, seven days a week at 1-888-235-HOPE (4673).
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