New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 67 - PSYCHOLOGICAL SERVICES › Subchapter 3 - CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) HEALTHCARE COMMON PROCEDURE CODING SYSTEM (HCPCS) CODE AND MAXIMUM FEE SCHEDULE FOR PSYCHOLOGICAL SERVICES › Section 10:67-3.3 - HCPCS Code qualifiers for psychological services

Current through Register Vol. 56, No. 14, July 15, 2024
Code
Narrative
90791
Initial Comprehensive Psychiatric
							 Evaluation
QUALIFIER: A Medicaid/NJ FamilyCare provider who is a
							 psychologist may bill this physician procedure code for parallel psychological
							 services. This code requires, for reimbursement purposes, a minimum of 50
							 minutes of face-to-face contact with the patient or family member.
90832
Individual Psychotherapy--approximately
							 20 to 30 minutes face-to-face with the patient
QUALIFIER: This code requires, for reimbursement
							 purposes, a minimum of 20 minutes of face-to-face contact with the patient or
							 family member.
90834
Individual Psychotherapy--approximately
							 45 to 50 minutes face-to-face with the patient
QUALIFIER: This code requires, for reimbursement
							 purposes, a minimum of 45 minutes of face-to-face contact with the patient or
							 family member.
90847
Family Therapy--50 minute session
QUALIFIER: A Medicaid/NJ FamilyCare provider who is a
							 psychologist may bill this physician procedure code for parallel psychological
							 services. This code requires, for reimbursement purposes, a minimum of 50
							 minutes of face-to-face contact with the patient or family member(s).
90847 22
Family Therapy--80 minute
							 session
QUALIFIER: A Medicaid/NJ FamilyCare provider who is a
							 psychologist may bill this physician procedure code for parallel psychological
							 services. This code requires, for reimbursement purposes, a minimum of 80
							 minutes of face-to-face contact with the patient or family member(s).
90853
Group psychotherapy by a psychologist
							 (other than of a multiple family group) 60-90 minutes
QUALIFIER: A Medicaid/NJ FamilyCare provider who is a
							 psychologist may bill this physician procedure code for parallel psychological
							 services. This code requires, for reimbursement purposes, a minimum of 60
							 minutes of face-to-face contact with the group members per session. One unit
							 equals 60 minutes for each person in the group with the maximum of eight
							 persons in the group.
90887
Family Conference--25 minute
							 session
QUALIFIER: A Medicaid/NJ FamilyCare provider who is a
							 psychologist may bill this physician procedure code for parallel psychological
							 services. This procedure code must be used in conjunction with the treatment of
							 the patient. This code requires, for reimbursement purposes, a minimum of 25
							 minutes of direct personal clinical involvement with the patient or family
							 member(s). The CPT narrative otherwise remains applicable.
96105
Assessment of aphasia with a written
							 report per hour.
QUALIFIER: The rate per hour includes time for
							 interpretation and reporting the results of the psychological testing,
							 including the cost of administration of the test and the scoring.
96150
Health and behavior assessment (for
							 example, health-focused clinical interview, behavioral observations,
							 psychophysiological monitoring and health-oriented questionnaires), each 15
							 minutes of face-to-face contact with the patient or family member; initial
							 assessment
QUALIFIER: A Medicaid/NJ FamilyCare provider who is a
							 psychologist may bill this physician procedure code for parallel psychological
							 services. This code requires, for reimbursement purposes, a minimum of 45
							 minutes of face-to-face contact with the patient or family member(s).
96151
Health and behavior re-assessment, each
							 15 minutes of face-to face contact with the patient or family member(s)
QUALIFIER: A Medicaid/NJ FamilyCare provider who is a
							 psychologist may bill this physician procedure code for parallel psychological
							 services. This code requires, for reimbursement purposes, a minimum of 30
							 minutes of face-to-face contact with the patient or family member(s).
96152
Health and behavior intervention, each
							 15 minutes of face-to-face contact with the patient
QUALIFIER: This code requires, for reimbursement
							 purposes, a minimum of 15 minutes of face-to-face contact with the patient or
							 family member.
96153
Health and behavior intervention, each
							 15 minutes of contact with a group (two or more patients, other than a multiple
							 family group)
QUALIFIER: A Medicaid/NJ FamilyCare provider who is a
							 psychologist may bill this physician procedure code for parallel psychological
							 services. This code requires, for reimbursement purposes, a minimum of 30
							 minutes per session. One unit equals 15 minutes for each person in the group,
							 with a maximum of eight persons in the group.
96154
Health and behavior intervention, each
							 15 minutes, with a family member (with the patient present)
QUALIFIER: A Medicaid/NJ FamilyCare provider who is a
							 psychologist may bill this physician procedure code for parallel psychological
							 services. This code requires, for reimbursement purposes, a minimum of 30
							 minutes of face-to-face contact with the patient and family member(s). One unit
							 equals 15 minutes for each person in the group.
96155
Health and behavior intervention, each
							 15 minutes, with a family member (without the patient present)
QUALIFIER: A Medicaid/NJ FamilyCare provider who is a
							 psychologist may bill this physician procedure code for parallel psychological
							 services. This code requires, for reimbursement purposes, a minimum of 30
							 minutes of face-to-face contact with the family member(s). One unit equals 15
							 minutes for each person in the group.