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Our blog bringing you the unique views of the people that make up Colorado Access.

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Heidi Warner

Heidi Warner is the marketing communications manager at Colorado Access. She enjoys words and culture, which led her to earn her Master of Arts degree in International & Intercultural Communication from the University of Denver. Heidi is an avid runner and brings a unique perspective having served as a small business development volunteer in the Peace Corps in Peru.

My Own Path

We’re all on our own path in life. Who we are today is a collection of our past experiences that make us what we are. None of us are alike, yet we all can relate to each other through similar feelings. As we shine a light on suicide in September through National Suicide Awareness and … Read More

I’m inquiring about services rendered during the COVID-19 pandemic. I believe that we currently have a waiver that indicates that signatures are not required on treatment plans and other financial documentation because of the barriers to obtaining client signatures with telephonic and/or telehealth rendered services. We are curious if we will need to go back and have those clients sign those documents once this waiver is ended?

For behavioral health, the clinician should make a note within the medical record that the member is unable to sign the documents due to the delivery method. If a member is unable to sign a document because the service was rendered by telehealth, this should be noted by the clinician. When the member is seen … Read More

What is the code for billing phone mental health therapy?

March 27, 2020: When billing a service conducted by the telephone, please use POS 02. CMS1500 Professional Claim Billing guidance: Capitated behavioral health billing (RAE/Colorado Access): For CMS1500 Professional Claim billing – Please use POS 02 for all telemedicine/telephone services rendered. Modifier 95 can also be added, though not required, as long as the placement … Read More

In regard to providing therapy through video conference (HIPAA compliant), I understand that the place of service is 02. I am wondering if the modifier remains HE, or should it be changed to GT? Or, is GT only for institutions?

March 27, 2020: Please continue to follow the USCS manual as it relates to the use of modifier HE, it should not be changed to GT. CMS1500 Professional Claim Billing guidance: Capitated behavioral health billing (RAE/Colorado Access): For CMS1500 Professional Claim billing – Please use POS 02 for all telemedicine/telephone services rendered. Modifier 95 can … Read More

Are telehealth copays suspended temporarily during the COVID-19 outbreak?

March 30, 2020: There are currently no copays for RAE behavioral health services. For CHP+ members, there currently is no copay for telehealth services provided for behavioral health services. There is a copay for telehealth services provided for physical health services and this will only be waived if the service is related to a COVID-19 … Read More

I have a question about GROUP Code 90853: An LMFT is setting up some group sessions for the parents/guardians and kids and she stated that is the code that would be billed per client. Is that a code Colorado Access reimburses for? Is there an updated list of codes, especially with teletherapy services being the only viable resource for families at this point?

March 27, 2020: The provider agreement details if there are any limitations on which codes. If there are no limitations in the provider agreement, then codes in the USCS may be billed to Colorado Access as long as they were rendered by someone with the appropriate credentials and documented according to the USCS manual. Colorado … Read More

Will the pay for teletherapy sessions 90837 90846 and 90847 be paid at the same rate as when they are when done in person? When doing play therapy with children using teletherapy and using interactive methods will 90785 still be accepted?

March 27, 2020: Yes, the reimbursement for the codes you mentioned below for Video Conferencing/ Telehealth services are the same as if the session was done face to face. Using telehealth does not qualify for interactive complexity. Rules concerning the use of interactive codes have not changed. Good clinical judgement is necessary to determine if … Read More