News Flash from the CTAAP Office
CTAAP shieldMedicaid Uses New CPT Code 96127 for Billing Behavioral Health Assessments (BH screens)

Connecticut's Department of Social Services loaded

CPT code 96127 to the physician office and outpatient fee schedule to be used for behavioral health assessments. Providers will be required to bill with the appropriate modifier (U3 or U4) similar to when billing for developmental screens. 

 

Effective for dates of service January 1, 2015 and forward there will be a new CPT code for billing behavioral health screens (BH screens).


96127 is a new code for "Brief emotional/behavioral assessment (e.g., depression inventory, ADHD scale) with scoring and documentation, per standardized instrument. " CT DSS also requires the use of modifiers U3 (positive screen) and U4 (negative screen) when billing for screens for patients under age 18 with HUSKY. 


96110 has been modified and now is defined as "Developmental screening (e.g., developmental milestone survey, speech and language delay screen) with scoring and documentation, per standardized instrument. CT DSS also requires the use of modifiers U3 (positive screen) and U4 (negative screen) when billing for screens for patients under age 18 with HUSKY.


As communicated in PB 2014-43, the Department requires physicians (excluding psychiatrists), APRNs (excluding psychiatric APRNs), and physician assistants to use modifiers U3 (positive developmental / BH screen) and U4 (negative developmental / BH screen) when billing for developmental and behavioral health screens for HUSKY Health clients under the age of eighteen. This policy will continue to be required for developmental screens billed as CPT code 96110, and effective for dates of service January 1, 2015 and forward, will be required for BH screens billed as CPT code 96127. Please refer to PB 2014-43 and PB 2014-58 for more information regarding developmental and behavioral health screens, including how to locate validated tools.


 

Download the Provider Bulletin: PB 2014-91 2015 HIPPA Update.pdf


 

Nina Holmes, MPH

Nina.Holmes@ct.gov

Department of Social Services

Division of Health Services

CTAAP
104 Hungerford Street
Hartford, CT  06106
www.ct-aap.org 
PHONE: 860-525-973
FAX: 860-727-9863