RFP 250000002670 - Appendix 3 - Historical Cost and Utilization Data.pdf

APPENDIX 3 – HISTORICAL COST AND UTILIZATION

DATA – MEDICAID BEHAVIORAL HEALTH PROGRAM

Request for Proposal No. 250000002670 Prepaid Inpatient Health Plan (PIHP)

See below for details.

MILLIMAN REPORT

Historical cost and utilization data – Medicaid

Behavioral Health Program Prepared for State of Michigan, Department of Health and Human

Services

July 2025

Jeremy Cunningham, FSA, MAAA

John Belanger, FSA, MAAA

Table of Contents

BACKGROUND

INTRODUCTION

REGIONS

POPULATIONS

SERVICE CATEGORIES

DATA EXHIBITS

CCBHC DEMONSTRATION

CAPITATION RATE ADJUSTMENTS

INITIAL KEY ADJUSTMENTS

LIMITATIONS

Historical cost and utilization data –

Medicaid Behavioral Health Program 1 July 2025

BACKGROUND

INTRODUCTION

To assist potential bidders in understanding the populations served by the Behavioral Health (BH) Medicaid program, Milliman, on behalf of the Michigan Department of Health and Human Services (MDHHS), has compiled information on service expenses for each of the three regions as defined currently in the procurement. The data is based on

State Fiscal Year (SFY) 2023 (October 1, 2022 – September 30, 2023) Period 3 Encounter Quality Initiative (EQI) data, which was provided by Community Mental Health Services Programs (CMHSPs) and historical Prepaid

Inpatient Health Plans (PIHPs). SFY 2023 encounter data was leveraged where EQI data was not available. These data sources form the foundation for the benefit expense and utilization statistics presented throughout this document. Additionally, eligibility information was summarized using extracts from MDHHS’s eligibility files. This data was used to determine the member months reflected in the summary tables included in this document. No adjustments have been applied to the data presented throughout this report. However, information regarding historical adjustments to base data used in the development of BH capitation rates has been provided in an effort to enable potential bidders to understand known changes to the program since SFY 2023.

It is important to note that SFY 2025 base data will be used for SFY 2027 capitation rate setting. In this report, SFY

2023 data is referenced because it forms the basis of the most recent MDHHS Behavioral Health Program SFY 2025 capitation rate certification.

REGIONS

MDHHS has defined three regions for the future BH managed care program: the Northern Region, Metro Region, and

Central Region. The information in this document has been summarized and organized according to these regions.

The table below lists the counties included in each region.

TABLE 1: LIST OF COUNTIES IN BH PROGRAM REGIONS

REGION COUNTIES

Central

Allegan, Arenac, Barry, Bay, Berrien, Branch, Calhoun, Cass, Clare, Clinton, Eaton, Genesee, Gladwin, Gratiot, Hillsdale, Huron, Ingham, Ionia, Isabella, Jackson, Kalamazoo, Kent, Lake, Lapeer, Lenawee, Livingston, Mason, Mecosta, Midland, Monroe, Montcalm, Muskegon, Newaygo, Oceana, Osceola, Ottawa, Saginaw, Sanilac, Shiawassee, St. Clair, St. Joseph, Tuscola, Van Buren, Washtenaw

Northern

Alcona, Alger, Alpena, Antrim, Baraga, Benzie, Charlevoix, Cheboygan, Chippewa, Crawford, Delta, Dickinson, Emmet, Gogebic, Grand Traverse, Houghton, Iosco, Iron, Kalkaska, Keweenaw, Leelanau, Luce, Mackinac, Manistee, Marquette, Menominee, Missaukee, Montmorency, Ogemaw, Ontonagon, Oscoda, Otsego, Presque Isle, Roscommon, Schoolcraft, Wexford

Metro Macomb, Oakland, Wayne

POPULATIONS

MDHHS operates a statewide behavioral health managed care program for the Disabled, Aged, and Blind (DAB);

Temporary Assistance for Needy Families (TANF); and Healthy Michigan Plan (HMP) populations, as well as three

1915(c) waiver populations:

▪ Children’s Waiver Program (CWP)

▪ Habilitation Supports Waiver (HSW)

▪ Serious Emotional Disturbance Waiver (SEDW)

Additionally, effective October 1, 2021, MDHHS began its Certified Community Behavioral Health Clinics (CCBHCs)

Demonstration Program under Section 223 of the Protecting Access to Medicare Act (PAMA). As of January 1, 2025, the Demonstration remains active with 23 Community Mental Health Service Programs (CMHSPs) and 12 non-profit organizations operating within the anticipated Central and Metro regions. During SFY 2023, the period the expense and eligibility information in this report covers, the Demonstration had 10 Community Mental Health Service

Programs and 3 non-profit organizations.

Services provided under the behavioral health managed care program include treatment for individuals with Serious

Mental Illness (SMI), Serious Emotional Disturbance (SED), Substance Use Disorder (SUD), and

Intellectual/Developmental Disabilities (I/DD). Mental health services include state plan, Early Periodic Screening, Medicaid Behavioral Health Program 2 July 2025

Diagnosis, and Treatment (EPSDT) services, 1915(i) waiver services, and 1915(c) waiver services. All substance abuse services are covered under the state plan. CCBHC Demonstration Program services reflect a subset of the mental health and SUD services included in this report.

SERVICE CATEGORIES

Milliman has provided summaries of the historical expenditures and utilization from SFY 2023 EQI submissions and encounter data by major Categories of Service (COS).

Refer to Appendix 1 for details on how service codes and the service categories included within the EQI templates were grouped to form the major service categories used in this document and its accompanying exhibits. For more information about the service categories included in Appendix 1, please refer to the Behavioral Health Code Sets and

Behavioral Health Code Charts and Provider Qualifications found on the MDHHS website under the reporting requirements for adult behavioral health and disability1.

DATA EXHIBITS

Appendix 2 of this report includes summarizations of PIHP-submitted SFY 2023 Period 3 EQI reports, which underly the base data for SFY 2025 BH program capitation rates. These summaries do not reflect any adjustments that were made to project SFY 2023 base data to SFY 2025 for the purpose of developing capitation rates. The exhibits distinguish between CCBHC and non-CCBHC services, enabling potential bidders to understand the scope of services within each region that may be delivered under the CCBHC Program.

Each exhibit contains the following information:

• The period underlying the figures: October 1, 2022 – September 1, 2023

• Region: The regional breakout of the data (Central, Northern, and Metro)

• Population: The specific population group covered under the BH program

• Disabled, Aged, and Blind (DAB)

• Temporary Assistance for Needy Families (TANF)

• Healthy Michigan Plan (HMP)

• Children’s Waiver Program (CWP)

• Habilitation Support Waiver (HSW)

• Serious Emotional Disturbance Waiver (SEDW)

The following metrics are provided for each of the population and regional selections:

• Member Months: Member months represent the total number of months that individuals were eligible to receive

BH program services during SFY 2023.

• Average Monthly Members: Member months divided by 12.

• Total Unique Recipients: The total number of unique beneficiaries that received one or more services during

SFY 2023.

• Service Category: Primary category of service provided under the BH program. Please see the Service

Category section for more details.

• Incurred Claims: Total expenditure amount for each service category according to the SFY 2023 EQI. These figures have not been adjusted for any of the prospective changes typically applied during capitation rate setting.

• Utilization: Utilization for each service category. This metric represents the sum of reported units in the SFY

2023 EQI and does not make any considerations for the different reporting units various services codes have within a single service category.

• Per Member Per Month (PMPM): PMPM cost reflects the incurred claims divided by the total member months for SFY 2023.

As described above, incurred claims and utilization are derived from the [Service UNC] worksheet of the SFY 2023

Period 3 Behavioral Health EQI. The purpose of this sheet is to capture the utilization and net Medicaid expenditures

1 MDHHS Reporting Requirements page: https://www.michigan.gov/mdhhs/keep-mi-healthy/mentalhealth/reporting

Medicaid Behavioral Health Program 3 July 2025 for each service code, program, and population combination of the reporting entity. In summarizing these metrics, we have excluded all expenditures and utilization associated with the following:

• Michigan’s Behavioral and Substance Use Disorder Health Home Programs

• Services provided to individuals without BH managed care eligibility, and

• Non-covered services provided to individuals with BH managed care eligibility.

Other expenditures incurred by PIHPs but not listed on the [Service UNC] worksheet were not included in the summarizations. These expenses include, but are not limited to, the following:

• Non-Benefit Expenses: Non-benefit expenses attributable to the behavioral health services, such as managed care administration, fraud prevention activities, taxes, and fees. This information is located in the [Non-Benefit

Expenses] worksheet of the EQI report.

• Other Expenses: Other expenses that cannot be attributed directly to an individual service but were incurred to fulfill responsibilities the CMHSP or PIHP is required to do in their contract with MDHHS. This includes items such as incurred but not reported (IBNR) expenses, Mental Health Code functions, services not reported as encounters, provider stability payments, and performance payments. This information is located in the [Other

Expenses] worksheet of the EQI report.

o As part of the SFY 2023 P3 EQI reports, the 10 PIHPs reported aggregate IBNR estimates of approximately 0.1% of the corresponding reported service cost amounts.

• Reconciling Items: Any expenses that account for difference in reporting between the EQI and Financial Status

Report (FSR). This includes items such as expenses covered by grants or general fund and any other expenses as determined by the reporting entity. These expenses can also be reported as negative values or credits. This information is located in the [Financial Reconciliation] worksheet of the EQI report.

Please refer to the Behavioral Health Encounter Data Quality Methodology and Instructions – SFY 2023 Period 32 for more information regarding the EQI.

One entity, Northern lakes Community Mental Health, did not report a SFY 2023 Period 3 Behavioral Health EQI report. In the absence of this data, SFY 2023 encounter cost and utilization amounts from claims originated by

Northern Lakes were used in the summary. This information represents encounter data submitted to MDHHS’s data warehouse as of August 3, 2024.

• The EQI report does not include the recipient or member month metrics used in this report. Enrollment and encounter data submitted to MDHHS’s data warehouse as of August 3, 2024 was used to obtain these metrics across all entities and populations. No additional adjustments were made to this data in this report.

CCBHC Demonstration Effective October 1, 2021, MDHHS began its CCBHC Demonstration Program under Section 223 of the PAMA. Ten

CMHSPs and three non-profit behavioral health entities (CCBHC Cohort 1) have participated in the CCBHC

Demonstration since its onset in SFY 2022 and span eight of the ten geographic regions. In SFY 2024, an additional twelve CMHSPs and five non-profit behavioral health entities (CCBHC Cohort 2) entered the CCBHC Demonstration.

Two more non-profit behavioral health entities and one CMHSP (CCBHC Cohort 3) entered the Demonstration in

SFY 2025. On January 1, 2025 two additional non-profit behavioral health entities entered the Demonstration. More information about MDHHS’s CCBHC Demonstration Program can be found on the MDHHS website.

MDHHS has selected the certified clinic-specific prospective payment system (PPS) daily rate (PPS-1) methodology for its Section 223 CCBHC Demonstration Program. The CCBHC PPS-1 rates have been built into the managed care

2 Behavioral Health Encounter Data Quality Methodology and Instructions – SFY 2023 Period 1: https://www.michigan.gov/mdhhs/-

/media/Project/Websites/mdhhs/Keeping-Michigan-Healthy/BH-DD/Reporting-Requirements/Encounter-Quality-Initiative-Templates/SFY- 2023/Period1/EQI_Methodology_and_Instructions.pdf?rev=5e1f0ad8781943fcb900f7ea7508eec8&hash=73A4D2F6B796FB47FB11041611AAA7F7

Medicaid Behavioral Health Program 4 July 2025 program since SFY 2022, using Option 2 of the CCBHC Demonstration Guidance.3 Our approach includes the following components:

• Incorporates part of the funding for CCBHC services into the base capitation rates;

• Wraparound CCBHC supplemental capitation payments made outside of the risk-based contract on a monthly basis to the PIHPs; and

• A reconciliation process is performed to ensure that actual funding owed to the CCBHC (daily visits multiplied by PPS-1 rate) is equal to the funding received through the base capitation and supplemental payments. Any variance resulting from the reconciliation will be paid to the CCBHC from the PIHPs, and to the PIHPs from

MDHHS.

Starting in SFY 2026, MDHHS plans to no longer include CCBHC Demonstration funding in the behavioral health managed care program. All CCBHCs will receive PPS reimbursement directly from MDHHS in SFY 2026 and 2027.

Michigan’s CCBHC Demonstration is currently scheduled to end at the conclusion of SFY 2027. Total projected

CCBHC funding, including funding through supplemental and base capitation payments, as included in SFY 2023 –

2025 rate certifications, has been included in this report as Appendix 3.

Starting in SFY 2023, individuals with a mild-to-moderate level of care, as defined by MDHHS, were funded entirely through the wraparound CCBHC supplemental capitation payment. These individuals did not historically receive services through the behavioral health program prior to the Demonstration.

CAPITATION RATE ADJUSTMENTS

Appendix 2 illustrates the SFY 2023 EQI benefit expense and utilization data, which have not been adjusted for capitation rate setting purposes. When developing capitation rates, the base data is adjusted to reflect changes that occur between the base period and the rating period. The following includes examples of key items that will require material adjustments to the SFY 2023 incurred cost data.

INITIAL KEY ADJUSTMENTS

The following initial key adjustments are required to adjust service costs from the base period to the rating period.

This list is not intended to be comprehensive of all adjustments that will be made for SFY 2027 capitation rates.

• IMD Removal: When developing Medicaid capitation rates, CMS requires the actuary to exclude services incurred during months where an individual resided in an Institution for Mental Disease (IMD) for more than 15 days in a calendar month, in accordance with the Medicaid and CHIP Managed Care Final Rule (CMS-2390-F).

• CCBHC Program: CCBHC services provided within the Demonstration will be excluded from the base data used to develop SFY 2027 capitation rates. CCBHC services provided outside of the Demonstration will continue to be paid through the capitation rates.

• Public Health Emergency (PHE) Acuity: As a result of the PHE unwinding, individuals who were disenrolled generally had lower Medicaid costs than those who remained enrolled, leading to higher average acuity of the underlying program membership.

• Unit Cost and Utilization Trend: The historical data will need to be adjusted to account for projected unit cost and utilization trend.

3 https://www.medicaid.gov/medicaid/financial-management/downloads/section-223-ccbh-pps-prop-updates-022024.pdf (Page 51)

Medicaid Behavioral Health Program 5 July 2025

LIMITATIONS

The information contained in this presentation has been prepared for the State of Michigan, Department of Health and Human Services and their consultants and advisors. It is our understanding that this letter may be utilized in a public document. To the extent that the information contained in this letter is provided to third parties, the letter should be distributed in its entirety. Any user of the data must possess a certain level of expertise in actuarial science and healthcare modeling so as not to misinterpret the data presented.

Milliman makes no representations or warranties regarding the contents of this letter to third parties. Likewise, third parties are instructed that they are to place no reliance upon this letter prepared for MDHHS by Milliman that would result in the creation of any duty or liability under any theory of law by Milliman or its employees to third parties.

Milliman has developed certain models to summarize historical cost and utilization data for MDHHS’ Behavioral

Health Program. We have reviewed the models, including their inputs, calculations, and outputs for consistency, reasonableness, and appropriateness to the intended purpose and in compliance with generally accepted actuarial practice and relevant actuarial standards of practice (ASOP).

The models rely on data and information as inputs to the models. We have relied upon certain data and information provided by MDHHS and its vendors for this purpose and accepted it without audit. To the extent that the data and information provided is not accurate, or is not complete, the values provided in this report may likewise be inaccurate or incomplete.

The models, including all inputs, calculations, and outputs may not be appropriate for any other purpose.

Guidelines issued by the American Academy of Actuaries require actuaries to include their professional qualifications in all actuarial communications. John Belanger and Jeremy Cunningham are members of the American Academy of

Actuaries and meet the qualification standards for performing the analyses in this report.

Appendix 1: Major Categories of Service

7/25/2025

State of Michigan, Department of Health and Human Services

Medicaid BH Program Procurement

Appendix 1 - Major Service Category Mapping

Service Code

MH, SUD, and/or

CCBHC Service Category Major Service Category Reporting Units

680100 MH Inpatient Inpatient Day

680114 MH Inpatient Inpatient Day

680124 MH Inpatient Inpatient Day

680134 MH Inpatient Inpatient Day

680154 MH Inpatient Inpatient Day

730100 MH Inpatient Inpatient Day

730114 MH Inpatient Inpatient Day

730124 MH Inpatient Inpatient Day

730134 MH Inpatient Inpatient Day

730154 MH Inpatient Inpatient Day

0370 MH Other Therapy Other Encounter

0710 MH Other Therapy Other Encounter

0901 MH Other Therapy Other Encounter

0906 SUD Outpatient Services SUD Outpatient Day

0912 MH Outpatient Services Other Day

0913 MH Outpatient Services Other Day

1002 SUD Residential Services Residential Services Day

00104 MH Other Therapy Other Minutes

001040901 MH Other Therapy Other Minutes

0362T MH Assessments and Testing Prevention, E&M, Assessments and Testing First 30 Minutes

0373T MH Autism Services Autism Services 15 Minutes

80305 SUD Outpatient Services SUD Outpatient Encounter

80306 SUD Outpatient Services SUD Outpatient Encounter

80307 SUD Outpatient Services SUD Outpatient Encounter

90785 MH, SUD, CCBHC Psychiatric diagnostic evaluation Prevention, E&M, Assessments and Testing Encounter

90785Y1 MH, SUD, CCBHC Psychiatric diagnostic evaluation Prevention, E&M, Assessments and Testing Encounter

90785Y2 MH, SUD, CCBHC Psychiatric diagnostic evaluation Prevention, E&M, Assessments and Testing Encounter

90785Y4 MH, SUD, CCBHC Psychiatric diagnostic evaluation Prevention, E&M, Assessments and Testing Encounter

90791 MH, SUD, CCBHC Psychiatric diagnostic evaluation Prevention, E&M, Assessments and Testing Encounter

90791QJ MH, SUD, CCBHC Psychiatric diagnostic evaluation Prevention, E&M, Assessments and Testing Encounter

90791WX MH, SUD, CCBHC Psychiatric diagnostic evaluation Prevention, E&M, Assessments and Testing Encounter

90791Y4 MH, SUD, CCBHC Psychiatric diagnostic evaluation Prevention, E&M, Assessments and Testing Encounter

90792 MH, SUD, CCBHC Psychiatric diagnostic evaluation Prevention, E&M, Assessments and Testing Encounter

90792QJ MH, SUD, CCBHC Psychiatric diagnostic evaluation Prevention, E&M, Assessments and Testing Encounter

90792WX MH, SUD, CCBHC Psychiatric diagnostic evaluation Prevention, E&M, Assessments and Testing Encounter

90792Y4 MH, SUD, CCBHC Psychiatric diagnostic evaluation Prevention, E&M, Assessments and Testing Encounter

90832 MH, CCBHC Psychotherapy Psychotherapy 30 Minutes

90832 SUD Outpatient Services SUD Outpatient 30 Minutes

90832QJ MH, CCBHC Psychotherapy Psychotherapy 30 Minutes

90832QJ SUD Outpatient Services SUD Outpatient 30 Minutes

90832ST MH, CCBHC Psychotherapy Psychotherapy 30 Minutes

90832ST SUD Outpatient Services SUD Outpatient 30 Minutes

90832STQJ MH, CCBHC Psychotherapy Psychotherapy 30 Minutes

90832STQJ SUD Outpatient Services SUD Outpatient 30 Minutes

90832Y1 MH, CCBHC Psychotherapy Psychotherapy 30 Minutes

90832Y1 SUD Outpatient Services SUD Outpatient 30 Minutes

90832Y2 MH, CCBHC Psychotherapy Psychotherapy 30 Minutes

90832Y2 SUD Outpatient Services SUD Outpatient 30 Minutes

90832Y4 MH, CCBHC Psychotherapy Psychotherapy 30 Minutes

90832Y4 SUD Outpatient Services SUD Outpatient 30 Minutes

90833 MH, CCBHC Psychotherapy Psychotherapy 30 Minutes

90833QJ MH, CCBHC Psychotherapy Psychotherapy 30 Minutes

90834 MH, CCBHC Psychotherapy Psychotherapy 45 Minutes

90834 SUD Outpatient Services SUD Outpatient 45 Minutes

90834QJ MH, CCBHC Psychotherapy Psychotherapy 45 Minutes

90834QJ SUD Outpatient Services SUD Outpatient 45 Minutes

90834ST MH, CCBHC Psychotherapy Psychotherapy 45 Minutes

90834ST SUD Outpatient Services SUD Outpatient 45 Minutes

90834STQJ MH, CCBHC Psychotherapy Psychotherapy 45 Minutes

90834STQJ SUD Outpatient Services SUD Outpatient 45 Minutes

90834Y1 MH, CCBHC Psychotherapy Psychotherapy 45 Minutes

90834Y1 SUD Outpatient Services SUD Outpatient 45 Minutes

90834Y2 MH, CCBHC Psychotherapy Psychotherapy 45 Minutes

90834Y2 SUD Outpatient Services SUD Outpatient 45 Minutes

90834Y4 MH, CCBHC Psychotherapy Psychotherapy 45 Minutes

90834Y4 SUD Outpatient Services SUD Outpatient 45 Minutes

90836 MH, CCBHC Psychotherapy Psychotherapy 45 Minutes

90836QJ MH, CCBHC Psychotherapy Psychotherapy 45 Minutes

90837 MH, CCBHC Psychotherapy Psychotherapy 60 Minutes

Appendix 1 Milliman Page 1

Medicaid BH Program Procurement

Appendix 1 - Major Service Category Mapping

Service Code

MH, SUD, and/or

CCBHC Service Category Major Service Category Reporting Units

90837 SUD Outpatient Services SUD Outpatient 60 Minutes

90837QJ MH, CCBHC Psychotherapy Psychotherapy 60 Minutes

90837QJ SUD Outpatient Services SUD Outpatient 60 Minutes

90837ST MH, CCBHC Psychotherapy Psychotherapy 60 Minutes

90837ST SUD Outpatient Services SUD Outpatient 60 Minutes

90837STQJ MH, CCBHC Psychotherapy Psychotherapy 60 Minutes

90837STQJ SUD Outpatient Services SUD Outpatient 60 Minutes

90837Y1 MH, CCBHC Psychotherapy Psychotherapy 60 Minutes

90837Y1 SUD Outpatient Services SUD Outpatient 60 Minutes

90837Y2 MH, CCBHC Psychotherapy Psychotherapy 60 Minutes

90837Y2 SUD Outpatient Services SUD Outpatient 60 Minutes

90837Y4 MH, CCBHC Psychotherapy Psychotherapy 60 Minutes

90837Y4 SUD Outpatient Services SUD Outpatient 60 Minutes

90838 MH, CCBHC Psychotherapy Psychotherapy 60 Minutes

90838QJ MH, CCBHC Psychotherapy Psychotherapy 60 Minutes

90839 MH, CCBHC Crisis Crisis First 30-74 Min.

90839QJ MH, CCBHC Crisis Crisis First 30-74 Min.

90839ST MH, CCBHC Crisis Crisis First 30-74 Min.

90839STQJ MH, CCBHC Crisis Crisis First 30-74 Min.

90839Y1 MH, CCBHC Crisis Crisis First 30-74 Min.

90839Y2 MH, CCBHC Crisis Crisis First 30-74 Min.

90839Y3 MH, CCBHC Crisis Crisis First 30-74 Min.

90839Y4 MH, CCBHC Crisis Crisis First 30-74 Min.

90840 MH, CCBHC Crisis Crisis Each Additional 30 Minutes

90840QJ MH, CCBHC Crisis Crisis Each Additional 30 Minutes

90840Y1 MH, CCBHC Crisis Crisis Each Additional 30 Minutes

90840Y2 MH, CCBHC Crisis Crisis Each Additional 30 Minutes

90840Y3 MH, CCBHC Crisis Crisis Each Additional 30 Minutes

90840Y4 MH, CCBHC Crisis Crisis Each Additional 30 Minutes

90846 MH, CCBHC Psychotherapy Psychotherapy 50 Minutes

90846 SUD Outpatient Services SUD Outpatient 50 Minutes

90846ST MH, CCBHC Psychotherapy Psychotherapy 50 Minutes

90846ST SUD Outpatient Services SUD Outpatient 50 Minutes

90846Y2 MH, CCBHC Psychotherapy Psychotherapy 50 Minutes

90846Y2 SUD Outpatient Services SUD Outpatient 50 Minutes

90846Y3 MH, CCBHC Psychotherapy Psychotherapy 50 Minutes

90846Y3 SUD Outpatient Services SUD Outpatient 50 Minutes

90846Y4 MH, CCBHC Psychotherapy Psychotherapy 50 Minutes

90846Y4 SUD Outpatient Services SUD Outpatient 50 Minutes

90847 MH, CCBHC Psychotherapy Psychotherapy 50 Minutes

90847 SUD Outpatient Services SUD Outpatient 50 Minutes

90847ST MH, CCBHC Psychotherapy Psychotherapy 50 Minutes

90847ST SUD Outpatient Services SUD Outpatient 50 Minutes

90847Y2 MH, CCBHC Psychotherapy Psychotherapy 50 Minutes

90847Y2 SUD Outpatient Services SUD Outpatient 50 Minutes

90847Y3 MH, CCBHC Psychotherapy Psychotherapy 50 Minutes

90847Y3 SUD Outpatient Services SUD Outpatient 50 Minutes

90847Y4 MH, CCBHC Psychotherapy Psychotherapy 50 Minutes

90847Y4 SUD Outpatient Services SUD Outpatient 50 Minutes

90849 MH, CCBHC Psychotherapy Psychotherapy Encounter

90849 SUD Outpatient Services SUD Outpatient Encounter

90849ST MH, CCBHC Psychotherapy Psychotherapy Encounter

90849ST SUD Outpatient Services SUD Outpatient Encounter

90849UN MH, CCBHC Psychotherapy Psychotherapy Encounter

90849UN SUD Outpatient Services SUD Outpatient Encounter

90849UNST MH, CCBHC Psychotherapy Psychotherapy Encounter

90849UNST SUD Outpatient Services SUD Outpatient Encounter

90849UNY2 MH, CCBHC Psychotherapy Psychotherapy Encounter

90849UNY2 SUD Outpatient Services SUD Outpatient Encounter

90849UNY3 MH, CCBHC Psychotherapy Psychotherapy Encounter

90849UNY3 SUD Outpatient Services SUD Outpatient Encounter

90849UNY4 MH, CCBHC Psychotherapy Psychotherapy Encounter

90849UNY4 SUD Outpatient Services SUD Outpatient Encounter

90849UP MH, CCBHC Psychotherapy Psychotherapy Encounter

90849UP SUD Outpatient Services SUD Outpatient Encounter

90849UPST MH, CCBHC Psychotherapy Psychotherapy Encounter

90849UPST SUD Outpatient Services SUD Outpatient Encounter

90849UPY2 MH, CCBHC Psychotherapy Psychotherapy Encounter

90849UPY2 SUD Outpatient Services SUD Outpatient Encounter

Appendix 1 Milliman Page 2

Medicaid BH Program Procurement

Appendix 1 - Major Service Category Mapping

Service Code

MH, SUD, and/or

CCBHC Service Category Major Service Category Reporting Units

90849UPY3 MH, CCBHC Psychotherapy Psychotherapy Encounter

90849UPY3 SUD Outpatient Services SUD Outpatient Encounter

90849UPY4 MH, CCBHC Psychotherapy Psychotherapy Encounter

90849UPY4 SUD Outpatient Services SUD Outpatient Encounter

90849UQ MH, CCBHC Psychotherapy Psychotherapy Encounter

90849UQ SUD Outpatient Services SUD Outpatient Encounter

90849UQST MH, CCBHC Psychotherapy Psychotherapy Encounter

90849UQST SUD Outpatient Services SUD Outpatient Encounter

90849UQY2 MH, CCBHC Psychotherapy Psychotherapy Encounter

90849UQY2 SUD Outpatient Services SUD Outpatient Encounter

90849UQY3 MH, CCBHC Psychotherapy Psychotherapy Encounter

90849UQY3 SUD Outpatient Services SUD Outpatient Encounter

90849UQY4 MH, CCBHC Psychotherapy Psychotherapy Encounter

90849UQY4 SUD Outpatient Services SUD Outpatient Encounter

90849UR MH, CCBHC Psychotherapy Psychotherapy Encounter

90849UR SUD Outpatient Services SUD Outpatient Encounter

90849URST MH, CCBHC Psychotherapy Psychotherapy Encounter

90849URST SUD Outpatient Services SUD Outpatient Encounter

90849URY2 MH, CCBHC Psychotherapy Psychotherapy Encounter

90849URY2 SUD Outpatient Services SUD Outpatient Encounter

90849URY3 MH, CCBHC Psychotherapy Psychotherapy Encounter

90849URY3 SUD Outpatient Services SUD Outpatient Encounter

90849URY4 MH, CCBHC Psychotherapy Psychotherapy Encounter

90849URY4 SUD Outpatient Services SUD Outpatient Encounter

90849US MH, CCBHC Psychotherapy Psychotherapy Encounter

90849US SUD Outpatient Services SUD Outpatient Encounter

90849USST MH, CCBHC Psychotherapy Psychotherapy Encounter

90849USST SUD Outpatient Services SUD Outpatient Encounter

90849USY2 MH, CCBHC Psychotherapy Psychotherapy Encounter

90849USY2 SUD Outpatient Services SUD Outpatient Encounter

90849USY3 MH, CCBHC Psychotherapy Psychotherapy Encounter

90849USY3 SUD Outpatient Services SUD Outpatient Encounter

90849USY4 MH, CCBHC Psychotherapy Psychotherapy Encounter

90849USY4 SUD Outpatient Services SUD Outpatient Encounter

90849Y2 MH, CCBHC Psychotherapy Psychotherapy Encounter

90849Y2 SUD Outpatient Services SUD Outpatient Encounter

90849Y3 MH, CCBHC Psychotherapy Psychotherapy Encounter

90849Y3 SUD Outpatient Services SUD Outpatient Encounter

90849Y4 MH, CCBHC Psychotherapy Psychotherapy Encounter

90849Y4 SUD Outpatient Services SUD Outpatient Encounter

90853UN MH, CCBHC Psychotherapy Psychotherapy Encounter

90853UN SUD Outpatient Services SUD Outpatient Encounter

90853UNQJ MH, CCBHC Psychotherapy Psychotherapy Encounter

90853UNQJ SUD Outpatient Services SUD Outpatient Encounter

90853UNY2 MH, CCBHC Psychotherapy Psychotherapy Encounter

90853UNY2 SUD Outpatient Services SUD Outpatient Encounter

90853UNY4 MH, CCBHC Psychotherapy Psychotherapy Encounter

90853UNY4 SUD Outpatient Services SUD Outpatient Encounter

90853UP MH, CCBHC Psychotherapy Psychotherapy Encounter

90853UP SUD Outpatient Services SUD Outpatient Encounter

90853UPQJ MH, CCBHC Psychotherapy Psychotherapy Encounter

90853UPQJ SUD Outpatient Services SUD Outpatient Encounter

90853UPY2 MH, CCBHC Psychotherapy Psychotherapy Encounter

90853UPY2 SUD Outpatient Services SUD Outpatient Encounter

90853UPY4 MH, CCBHC Psychotherapy Psychotherapy Encounter

90853UPY4 SUD Outpatient Services SUD Outpatient Encounter

90853UQ MH, CCBHC Psychotherapy Psychotherapy Encounter

90853UQ SUD Outpatient Services SUD Outpatient Encounter

90853UQQJ MH, CCBHC Psychotherapy Psychotherapy Encounter

90853UQQJ SUD Outpatient Services SUD Outpatient Encounter

90853UQY2 MH, CCBHC Psychotherapy Psychotherapy Encounter

90853UQY2 SUD Outpatient Services SUD Outpatient Encounter

90853UQY4 MH, CCBHC Psychotherapy Psychotherapy Encounter

90853UQY4 SUD Outpatient Services SUD Outpatient Encounter

90853UR MH, CCBHC Psychotherapy Psychotherapy Encounter

90853UR SUD Outpatient Services SUD Outpatient Encounter

90853URQJ MH, CCBHC Psychotherapy Psychotherapy Encounter

90853URQJ SUD Outpatient Services SUD Outpatient Encounter

90853URY2 MH, CCBHC Psychotherapy Psychotherapy Encounter

Appendix 1 Milliman Page 3

Medicaid BH Program Procurement

Appendix 1 - Major Service Category Mapping

Service Code

MH, SUD, and/or

CCBHC Service Category Major Service Category Reporting Units

90853URY2 SUD Outpatient Services SUD Outpatient Encounter

90853URY4 MH, CCBHC Psychotherapy Psychotherapy Encounter

90853URY4 SUD Outpatient Services SUD Outpatient Encounter

90853US MH, CCBHC Psychotherapy Psychotherapy Encounter

90853US SUD Outpatient Services SUD Outpatient Encounter

90853USQJ MH, CCBHC Psychotherapy Psychotherapy Encounter

90853USQJ SUD Outpatient Services SUD Outpatient Encounter

90853USY2 MH, CCBHC Psychotherapy Psychotherapy Encounter

90853USY2 SUD Outpatient Services SUD Outpatient Encounter

90853USY4 MH, CCBHC Psychotherapy Psychotherapy Encounter

90853USY4 SUD Outpatient Services SUD Outpatient Encounter

90863 MH Other Other Encounter

90870 MH Other Other Encounter

908700901 MH Other Other Encounter

90887 MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Encounter

92507 MH Other Therapy Other Encounter

92508 MH Other Therapy Other Encounter

92521 MH Other Therapy Other Encounter

92522 MH Other Therapy Other Encounter

92523 MH Other Therapy Other Encounter

92524 MH Other Therapy Other Encounter

92526 MH Other Therapy Other Encounter

92607 MH Other Therapy Other First Hour

92608 MH Other Therapy Other Each Additional 30 Minutes

92609 MH Other Therapy Other Encounter

92610 MH Other Therapy Other Encounter

92626 MH Other Other First Hour

92627 MH Other Other Each Additional 15 Minutes

92630 MH Other Other Encounter

92633 MH Other Other Encounter

96105 MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Encounter

96105WX MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Encounter

96110 MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Encounter

96110QJ MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Encounter

96110WX MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Encounter

96112 MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing First Hour

96112QJ MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing First Hour

96112WX MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing First Hour

96113 MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Each Additional 30 Minutes

96113QJ MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Each Additional 30 Minutes

96113WX MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Each Additional 30 Minutes

96116 MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Per Hour

96116WX MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Per Hour

96121 MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Each Additional Hour

96127 MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Encounter

96127WX MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Encounter

96130 MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing First Hour

96130QJ MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing First Hour

96131 MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Each Additional Hour

96131QJ MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Each Additional Hour

96132 MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing First Hour

96133 MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Each Additional Hour

96136 MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing First 30 Minutes

96136QJ MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing First 30 Minutes

96137 MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Each Additional 30 Minutes

96137QJ MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Each Additional 30 Minutes

96138 MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing First 30 Minutes

96139 MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Each Additional 30 Minutes

96146 MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Encounter

96372 MH, SUD, CCBHC Medication Administration Medication Administration/Medication Assisted Treatment Encounter

96372QJ MH, SUD, CCBHC Medication Administration Medication Administration/Medication Assisted Treatment Encounter

96372Y4 MH, SUD, CCBHC Medication Administration Medication Administration/Medication Assisted Treatment Encounter

97110 MH Other Therapy Other 15 Minutes

97112 MH Other Therapy Other 15 Minutes

97113 MH Other Therapy Other 15 Minutes

97116 MH Other Therapy Other 15 Minutes

97124 MH Other Therapy Other 15 Minutes

97129 MH Other Therapy Other 15 Minutes

97130 MH Other Therapy Other 15 Minutes

Appendix 1 Milliman Page 4

Medicaid BH Program Procurement

Appendix 1 - Major Service Category Mapping

Service Code

MH, SUD, and/or

CCBHC Service Category Major Service Category Reporting Units

97140 MH Other Therapy Other 15 Minutes

97150 MH Other Therapy Other Encounter

97151 MH Assessments and Testing Prevention, E&M, Assessments and Testing 15 Minutes

97151U5 MH Assessments and Testing Prevention, E&M, Assessments and Testing 15 Minutes

97153 MH Autism Services Autism Services 15 Minutes

97154UN MH Autism Services Autism Services 15 Minutes

97154UP MH Autism Services Autism Services 15 Minutes

97154UQ MH Autism Services Autism Services 15 Minutes

97154UR MH Autism Services Autism Services 15 Minutes

97154US MH Autism Services Autism Services 15 Minutes

97155 MH Autism Services Autism Services 15 Minutes

97156 MH Autism Services Autism Services 15 Minutes

97157UN MH Autism Services Autism Services 15 Minutes

97157UP MH Autism Services Autism Services 15 Minutes

97157UQ MH Autism Services Autism Services 15 Minutes

97157UR MH Autism Services Autism Services 15 Minutes

97157US MH Autism Services Autism Services 15 Minutes

97158 MH Autism Services Autism Services 15 Minutes

97158UN MH Autism Services Autism Services 15 Minutes

97158UP MH Autism Services Autism Services 15 Minutes

97158UQ MH Autism Services Autism Services 15 Minutes

97158UR MH Autism Services Autism Services 15 Minutes

97158US MH Autism Services Autism Services 15 Minutes

97161 MH Other Therapy Other Encounter

97161WX MH Other Therapy Other Encounter

97162 MH Other Therapy Other Encounter

97162WX MH Other Therapy Other Encounter

97163 MH Other Therapy Other Encounter

97163WX MH Other Therapy Other Encounter

97164 MH Other Therapy Other Encounter

97165 MH Other Therapy Other Encounter

97165WX MH Other Therapy Other Encounter

97166 MH Other Therapy Other Encounter

97166WX MH Other Therapy Other Encounter

97167 MH Other Therapy Other Encounter

97167WX MH Other Therapy Other Encounter

97168 MH Other Therapy Other Encounter

97168WX MH Other Therapy Other Encounter

97530 MH Other Therapy Other 15 Minutes

97530Y4 MH Other Therapy Other 15 Minutes

97533 MH Other Therapy Other 15 Minutes

97535 MH Other Therapy Other 15 Minutes

97537 MH Other Therapy Other 15 Minutes

97542 MH Other Therapy Other 15 Minutes

97750 MH Other Therapy Other 15 Minutes

97755 MH Other Therapy Other 15 Minutes

97760 MH Other Therapy Other 15 Minutes

97761 MH Other Other 15 Minutes

97763 MH Other Therapy Other 15 Minutes

97802 MH Assessments and Testing Prevention, E&M, Assessments and Testing 15 Minutes

97802WX MH Assessments and Testing Prevention, E&M, Assessments and Testing 15 Minutes

97803 MH Assessments and Testing Prevention, E&M, Assessments and Testing 15 Minutes

97803WX MH Assessments and Testing Prevention, E&M, Assessments and Testing 15 Minutes

97804 MH Other Therapy Other 30 Minutes

97804UN MH Other Therapy Other 30 Minutes

97804UP MH Other Therapy Other 30 Minutes

97804UQ MH Other Therapy Other 30 Minutes

97804UR MH Other Therapy Other 30 Minutes

97804US MH Other Therapy Other 30 Minutes

97810 SUD Other Other Encounter

97811 SUD Other Other Encounter

98966 MH Other Other Encounter

98967 MH Other Other Encounter

98968 MH Other Other Encounter

99202 MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99202QJ MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99202Y4 MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99203 MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99203QJ MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

Appendix 1 Milliman Page 5

Medicaid BH Program Procurement

Appendix 1 - Major Service Category Mapping

Service Code

MH, SUD, and/or

CCBHC Service Category Major Service Category Reporting Units

99203Y4 MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99204 MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99204QJ MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99204Y4 MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99205 MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99205QJ MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99205Y4 MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99211 MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99211QJ MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99211Y4 MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99212 MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99212QJ MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99212Y4 MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99213 MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99213QJ MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99213Y4 MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99214 MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99214QJ MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99214Y4 MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99215 MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99215QJ MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99215Y4 MH, SUD, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99221 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99222 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99223 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99223Y4 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99224 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99225 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99226 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99231 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99231Y4 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99232 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99232Y4 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99233 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99233Y4 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99238 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99239 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99304 MH Evaluation and Management Prevention, E&M, Assessments and Testing 25 minutes

99305 MH Evaluation and Management Prevention, E&M, Assessments and Testing 35 Minutes

99306 MH Evaluation and Management Prevention, E&M, Assessments and Testing 45 Minutes

99307 MH Evaluation and Management Prevention, E&M, Assessments and Testing 10 Minutes

99308 MH Evaluation and Management Prevention, E&M, Assessments and Testing 15 Minutes

99309 MH Evaluation and Management Prevention, E&M, Assessments and Testing 25 minutes

99310 MH Evaluation and Management Prevention, E&M, Assessments and Testing 35 Minutes

99324 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99325 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99326 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99327 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99328 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99334 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99335 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99336 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99337 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99341 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99342 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99343 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99344 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99345 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99347 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99347Y4 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99348 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99349 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99350 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99354 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99355 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99381 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99382 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99383 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99384 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

Appendix 1 Milliman Page 6

Medicaid BH Program Procurement

Appendix 1 - Major Service Category Mapping

Service Code

MH, SUD, and/or

CCBHC Service Category Major Service Category Reporting Units

99385 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99386 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99387 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99391 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99392 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99393 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99394 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99395 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99396 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99397 MH, CCBHC Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99415 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99416 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99417 MH Evaluation and Management Prevention, E&M, Assessments and Testing Encounter

99441 MH Other Other Encounter

99442 MH Other Other Encounter

99443 MH Other Other Encounter

99506 MH, CCBHC Medication Administration Medication Administration/Medication Assisted Treatment Encounter

99506Y4 MH, CCBHC Medication Administration Medication Administration/Medication Assisted Treatment Encounter

A0080 MH Other Other Per mile

A0090 MH Other Other Per mile

A0100 MH, SUD Other Other Per one-way trip

A0110 MH, SUD Other Other Per one-way trip

A0120 MH Other Other Per one-way trip

A0120Y4 MH Other Other Per one-way trip

A0130 MH Other Other Per one-way trip

A0140 MH Other Other Per one-way trip

A0425 MH Other Other Per Mile

A0427 MH Other Other Refer to code descriptions.

E1399 MH Other Other Item

G0176 MH, CCBHC Other Therapy Other Encounter

G0177 MH, CCBHC Other Other Encounter Session at least 45 min

G0177UN MH, CCBHC Other Other Encounter Session at least 45 min

G0177UNY4 MH, CCBHC Other Other Encounter Session at least 45 min

G0177UP MH, CCBHC Other Other Encounter Session at least 45 min

G0177UPY4 MH, CCBHC Other Other Encounter Session at least 45 min

G0177UQ MH, CCBHC Other Other Encounter Session at least 45 min

G0177UQY4 MH, CCBHC Other Other Encounter Session at least 45 min

G0177UR MH, CCBHC Other Other Encounter Session at least 45 min

G0177URY4 MH, CCBHC Other Other Encounter Session at least 45 min

G0177US MH, CCBHC Other Other Encounter Session at least 45 min

G0177USY4 MH, CCBHC Other Other Encounter Session at least 45 min

G0177Y4 MH, CCBHC Other Other Encounter Session at least 45 min

G0409 SUD Outpatient Services SUD Outpatient 15 Minutes

G0466 MH Other Other Encounter

G0467 MH Other Other Encounter

G0469 MH Other Other Encounter

G0470 MH Other Other Encounter

G2067 SUD Medication Assisted Treatment Medication Administration/Medication Assisted Treatment 1 per week

G2068 SUD Medication Assisted Treatment Medication Administration/Medication Assisted Treatment 1 per week

G2073 SUD Medication Assisted Treatment Medication Administration/Medication Assisted Treatment 1 per month

G2074 SUD Medication Assisted Treatment Medication Administration/Medication Assisted Treatment 1 per week

G2076 SUD Medication Assisted Treatment Medication Administration/Medication Assisted Treatment 1 per week

G2077 SUD Medication Assisted Treatment Medication Administration/Medication Assisted Treatment 1 per year

G2077Y4 SUD Medication Assisted Treatment Medication Administration/Medication Assisted Treatment 1 per year

G2078 SUD Medication Assisted Treatment Medication Administration/Medication Assisted Treatment 1 per week

G2079 SUD Medication Assisted Treatment Medication Administration/Medication Assisted Treatment 1 per week

G2080 SUD Medication Assisted Treatment Medication Administration/Medication Assisted Treatment 1 per week

G2251 MH Other Other Encounter

H0001 SUD, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Encounter

H0001QJ SUD, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Encounter

H0001Y4 SUD, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Encounter

H0002 MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Encounter

H0002QJ MH, CCBHC Assessments and Testing Prevention, E&M, Assessments and Testing Encounter

H0002WX MH, CCBHC Assessments and Testing Prevention, E&M, Assessments…