Date: April 20, 2020
To: Community Mental Health Centers, Behavioral Health Clinics, and Substance Use Prevention and Recovery Providers
Re: Claim Coding Clarification and Group Therapy for Community Mental Health Centers, Behavioral Health Clinics, and Substance Use Prevention and Recovery (SUPR) Providers
This notice provides clarification for the use of modifier GT and Place of Service 02, and also provides instructions for group therapy services provided via telehealth. The instructions will apply to claims for participants covered under fee-for-service as well as HealthChoice Illinois managed care plans and the Medicare/Medicaid Alignment Initiative (MMAI) plans.
Modifier GT and Place of Service 02 to Denote Telehealth Delivery of Service
By informational notice dated March 30, 2020, CMHCs and BHCs currently are not required to use modifier GT and Place of Service Code 02 as the distant site provider for services provided by phone. However, to better monitor the use of telehealth services, providers will be required to start using this coding effective 60 days after the public health emergency ends. The Department will release additional information as that time approaches.
Substance Use Prevention and Recovery (SUPR) providers
SUPR providers will also be required to start using modifier GT and Place of Service Code 02 coding on claims effective 60 days after the public health emergency ends. The Department will release additional information as that time approaches.
Group Therapy via Telehealth
Group mental health and substance use counseling that was previously performed face to face with clients may now be done via telehealth (video or telephone) with persons in their home. The use of telehealth to deliver group counseling services may create potential risks to the confidentiality of information shared in the group session, as other household members may overhear personal information shared. Therefore, the Department strongly encourages providers to update their consent procedures to ensure that clients fully understand the risks to confidentiality of information shared during group counseling sessions conducted via video or telephone.
Questions regarding this notice may be directed to the following offices:
CMHC and BHC providers, please contact the Bureau of Behavioral Health via telephone at 217-557-1000 or via email at HFS.BBH@illinois.gov.
Interim Medicaid Administrator