Arkansas Administrative Code
Agency 016 - DEPARTMENT OF HUMAN SERVICES
Division 06 - Medical Services
Rule 016.06.05-089 - Rehabilitative Services for Youth and Children Provider Manual Update Transmittal #19; Licensed Mental Health Practitioner Provider Manual Update Transmittal #49; ARKids First-B Provider Manual Update Transmittal #28; School-Based Mental Health Services Provider Manual Update Transmittal #22
Current through Register Vol. 49, No. 9, September, 2024
Section II Rehabilitative Services for Youth and Children
The following pages contain a listing of Arkansas Medicaid Rehabilitative Services for Youth and Children (RSYC) Codes that pertain to services covered by the Division of Youth Services (DYS). It is important to use the Medicaid code listing. All codes must have five digits.
NOTE: Effective for claims received on or after December 5, 2005, modifier UB must be used as described below.
|
Procedure Code |
Required Modifier |
Description |
|
96100 |
UB |
PSYCHOLOGICAL TESTING BATTERY This code will only be used for the retroactive billing period. 1 unit = test battery |
|
H2020 |
- |
EMERGENCY SHELTER 1 unit = 1 day |
|
H2020 |
U1 |
THERAPEUTIC FOSTER CARE 1 unit = 1 day |
|
H2020 |
U2 |
THERAPEUTIC GROUP HOME 1 unit = 1 day |
|
H2020 |
U4 |
RESIDENTIAL TREATMENT SERVICES 1 unit = 1 day |
|
90801 |
- |
DIAGNOSIS AND EVALUATION 1 unit = 15 minutes |
|
90804 |
- |
INDIVIDUAL PSYCHOTHERAPY 1 unit = 15 minutes |
|
90853 |
- |
GROUP PSYCHOTHERAPY 1 unit = 15 minutes |
Section II
Licensed Mental Health Practitioner
The following services are billed on a per unit basis. Unless otherwise specified in the appropriate CPT or HCPCS book, one unit equals 15 minutes. Services less than 15 minutes in duration are not reimbursable. Services billed on a per hour basis according to CPT or HCPCS must be billed for a full hour of service. Services less than 1 hour are not reimbursable. See section 251.000 for instructions for billing more than full units.
NOTE: Effective for claims received on or after December 5, 2005, modifiers UA and/or UB must be used with the appropriate procedure codes as described below.
|
Procedure Code |
Required Modifier |
Type of Service Code |
Description |
Length of Service |
|
90801 |
U1 |
Diagnosis Direct clinical service provided by a licensed mental health practitioner for the purpose of determining the existence, type, nature and most appropriate treatment of a mental illness or related disorder as described in the DSM-IV. This psychodiagnostic process may include but is not limited to a psychosocial and medical history, diagnostic findings and recommendations. |
8 unit maximum per day. |
|
|
96100 |
- |
Diagnosis-Psychological Test/Evaluation Payable only to psychologists. A single diagnostic test administered to a client by a licensed psychologist. This procedure should reflect the mental abilities, aptitudes, interests, attitudes, motivation, emotional and personality characteristics of the client. |
8 unit maximum per day. |
|
|
96100 |
UA, UB |
9 |
Diagnosis-Psychological Testing-Battery Payable only to psychologists. Two (2) or more diagnostic tests administered to a client by a psychologist. This battery should assess the mental abilities, aptitudes, interests, attitudes, emotions, motivation and personality characteristics of the client. |
8 unit maximum per day. |
|
90887 |
- |
Interpretation of Diagnosis A direct service provided by a licensed mental health practitioner for the purpose of interpreting the results of diagnostic activities to the patient and/or significant others. If significant others are involved, appropriate consent forms may need to be obtained. |
4 unit maximum per day. |
|
|
H2011 (Psychologist) H0046 (LCSW, LMFT, LPC) |
Crisis Management Visit An unscheduled direct service contact between an identified patient and a licensed mental health practitioner for the purpose of preventing an inappropriate or more restrictive placement. |
4 unit maximum per day. |
||
|
H0004 |
- |
Individual Outpatient-Therapy Session Scheduled individual outpatient care provided by a licensed mental health practitioner to a patient for the purposes of treatment and remediation of a condition described in DSM-IV and subsequent revisions. |
4 unit maximum per day. |
|
|
90847 90847 |
U1 U2 |
F 1 |
Marital/Family Therapy Family therapy shall be treatment provided to two or more family members and conducted by a licensed mental health practitioner for the purpose of alleviating conflict and promoting harmony. |
6 unit maximum per day. |
|
H0046 (Psychologist) H0046 (LCSW, LMFT, LPC) |
U2 U1 |
1 F |
Individual Outpatient-Collateral Services A face-to-face contact by a licensed mental health practitioner with other professionals, caregivers or other parties on behalf of an identified patient to obtain relevant information necessary to the patient's assessment, evaluation and treatment. |
4 unit maximum per day. |
|
90853 90857 |
- |
Group Outpatient-Group Therapy A direct-service contact between a group of patients and a LCSW, LMFT or LPC for the purposes of treatment and remediation of a psychiatric condition. |
6 unit maximum per day. |
|
|
90853 90857 |
U1 U1 |
Group Outpatient-Group Therapy A direct-service contact between a group of patients and a psychologist for the purposes of treatment and remediation of a psychiatric condition. |
6 unit maximum per day |
Section II
ARKids First-B
|
National Code |
Required Modifier |
Local Code |
Local Code Description |
|
92507 |
- |
Z1926 |
Individual Speech Session |
|
92508 |
- |
Z1927 |
Group Speech Session |
|
92507 |
UB |
Z2265 |
Individual Speech Therapy by Speech Language Pathology Assistant |
|
92508 |
- |
Z2266 |
Group Speech Therapy by Speech Language Pathology Assistant |
|
92506 |
- |
- |
- |
Section II
School-Based Mental Health Services
The following is a list of covered services available in the School-Based Mental Health Services Program. Practitioners enrolled as school-based mental health services provider personnel may provide the services on this list according to their scope of practice as identified by the licensure requirements.
The services are billed on a per unit basis. One unit equals 15 minutes. Services less than 15 minutes in duration are not reimbursable. The unit maximum shown below each procedure code description is a daily maximum.
NOTE: Effective for claims received on or after December 5, 2005, modifier UB must be used as described below.
|
Procedure Code |
Required Modifier |
Description and Definition |
Length of Service |
|
90801 |
- |
Diagnosis Direct clinical service provided by school-based mental health services provider personnel for the purpose of determining the existence, type, nature and most appropriate treatment of a mental illness or related disorder as described in the DSM-IV. This psycho-diagnostic process may include, but not be limited to, a psychosocial and medical history, diagnostic findings and recommendations. |
8-unit maximum |
|
96100 |
- |
Diagnosis - Psychological Test/Evaluation A single diagnostic test administered to a client by school-based mental health services provider personnel. This procedure should reflect the mental abilities, aptitudes, interests, attitudes, motivation, emotional and personality characteristics of the client. |
8-unit maximum |
|
96100 |
UB |
Diagnosis - Psychological Testing-Battery Two (2) or more diagnostic tests administered to a client by school-based mental health services provider personnel. This battery should assess the mental abilities, aptitudes, interests, attitudes, emotions, motivation and personality characteristics of the client. |
8-unit maximum |
|
90887 |
- |
Interpretation of Diagnosis A direct service provided by school-based mental health services provider personnel for the purpose of interpreting the results of diagnostic activities to the patient and/or significant others. If significant others are involved, appropriate consent forms may need to be obtained. |
4-unit maximum |
|
H0046 |
- |
Crisis Management Visit An unscheduled direct service contact between an identified patient and school-based mental health services provider personnel for the purpose of preventing an inappropriate or more restrictive placement. |
4-unit maximum |
|
H0004 |
- |
Individual Outpatient - Therapy Session Scheduled individual outpatient care provided by school-based mental health services provider personnel to a patient for the purposes of treatment and remediation of a condition described in DSM-IV and subsequent revisions. |
4-unit maximum |
|
90847 |
U6 |
Marital/Family Therapy Family therapy shall be treatment provided to two or more family members and conducted by school-based mental health services provider personnel for the purpose of alleviating conflict and promoting harmony. |
6-unit maximum |
|
H0046 |
- |
Individual Outpatient - Collateral Services A face-to-face contact by school-based mental health services provider personnel with other professionals, caregivers or other parties on behalf of an identified patient to obtain relevant information necessary to the patient's assessment, evaluation and treatment. |
4-unit maximum |
|
90853 |
- |
Group Outpatient - Group Therapy A direct service contact between a group of patients and school-based mental health services provider personnel for the purposes of treatment and remediation of a psychiatric condition |
6-unit maximum |
