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2012 Texas Medicaid Provider Procedures Manual

Behavioral Health, Rehabilitation, and Case Management Services Handbook : 6. Physician, Psychologist, and Licensed Psychological Associate (LPA) Providers : 6.7 Family Therapy or Counseling Services : 6.7.3 Reimbursement

6.7.3
Regardless of the number of family members present per outpatient session, family counseling or psychotherapy (procedure code 90847) is reimbursed for only one Medicaid-eligible client per session.
Procedure code 90847 is limited to one outpatient service per family, per day.
Psychiatric diagnostic interviews (procedure code 90801 or 90802), pharmacological regimen oversight (procedure code M0064), pharmacological management (procedure code 90862), and any E/M service will be denied as part of family outpatient psychotherapy or counseling (procedure code 90847).
Texas Medicaid implemented mandated rate reductions for certain services. The OFL and static fee schedules include a column titled “Adjusted Fee” to display the individual fees with all mandated percentage reductions applied.
Additional information about rate changes is available on the TMHP website at www.tmhp.com/pages/topics/rates.aspx.
Note:
Certain rate reductions including, but not limited to, reductions by place of service, client type program, or provider specialty may not be reflected in the Adjusted Fee column.

Texas Medicaid & Healthcare Partnership
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