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

Universal Citation: NJ Admin Code 10:67-3.3
Current through Register Vol. 56, No. 18, September 16, 2024

CodeNarrative
90791Initial 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.
90832Individual 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.
90834Individual 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.
90847Family 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).
90853Group 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.
90887Family 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.
96105Assessment 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.
96150Health 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).
96151Health 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).
96152Health 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.
96153Health 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.
96154Health 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.
96155Health 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.

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