Clarification - Psychotropic Medication Monitoring Replacement Code H2010


Communication Alert -

Clarification - Psychotropic Medication Monitoring Replacement Code H2010

Division of Mental Health staff have received several questions from providers regarding the reimbursement rate for the replacement code for psychotropic medication monitoring, as well as the "B" displayed in column 6 of the matrix referenced in the Communication Alert distributed yesterday, February 23rd, 2015.

This follow-up is being issued to provide clarification with regard to these questions.

The rates for H2010 remain the same as the rates for M0064. H2010 is simply the replacement code for M0064 which was used (or should be used) to bill for services rendered prior to January 1, 2015. The "B" displayed in the matrix referred to the classification of services reflected in the Service Definition Reimbursement Guide (e.g. Group B Services: Medicaid services governed by 59 Ill. Adm. Code 132.150 and 132.165). The B has been removed from the matrix below.

Place of Service
HCPCS Code Modifier Practice Level Mode Unit of Service On site (11) Home (12) Off-Site (99)
H2010 52 Non-APN/Doc Individual .25 $20.02 $20.02 $20.02
H2010 SA APN Individual .25 $24.12 $24.12 $24.12
H2010 Doc Individual .25 $24.44 $24.44 $24.44


Mary E. Smith, Ph.D.
Associate Director

Decision Support, Research and Evaluation
Division of Mental Health