DATE: December 26, 2012

TO: DMH CMHC Providers

FROM: Mary E. Smith, Ph.D., Associate Director
Decision Support, Research and Evaluation

RE: Change in CPT Billing Code Effective January 1, 2013

As many of you may know, the American Medical Association (AMA) has required changes in the Current Procedural Terminology (CPT) codes for psychiatry and psychotherapy services effective at the start of calendar year 2013. However, the only code that will change for DMH contracted providers is 90862- Psychotropic Medication Monitoring.

As a reminder, the current codes which are effective through 12/31/12 are:

Code Service
90862 52  Psychotropic medication monitoring
90862  SA  B  Psychotropic medication monitoring (APN)
90862  B Psychotropic medication monitoring (MH/DO/DC)

HFS has indicated that the following replacement codes must be used effective 1/1/13:

Codes Services
M0064  52  SA Psychotropic medication monitoring
M0064  SA Psychotropic medication monitoring (APN)
M0064 Psychotropic medication monitoring (MH/DO/DC)
Please note that the rates will remain the same; only the CPT codes are changing. Additional guidance will be forthcoming from HFS and DHS/DMH regarding when the HFS billing system will be ready to accept the new codes, updates to the Service Definition Reimbursement Guide )SDRG) etc.