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Delegated Psychological Services to Allow More Than One Modifier on the Same Date of Service Effective July 1, 2019

Last updated on 5/17/2019

Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details.

Effective for dates of service on or after July 1, 2019, delegated psychological services submitted with more than one modifier on the same date of service will be allowed to process without denial.

Delegated Services Modifiers

Currently, claims for psychological services submitted with more than one modifier for services rendered on the same date of service will deny.

Beginning July 1, 2019, claims submitted by a psychologist, licensed psychological associate (LPA), provisionally licensed psychologist (PLP), psychology intern, or post-doctoral fellow for psychological services must be billed with an appropriate modifier on each detail line of the claim, for each date of service, for each provider.

The following modifiers are to be used with procedure codes for licensed psychologists and those delegated to provide services:

Modifier

Description

AH

Clinical psychologist

UB

Identifies service provided by a pre-doctoral psychology intern or post-doctoral psychology fellow

UC

Identifies service provided by an LPA

U9

Identifies service provided by a PLP

One claim detail line must be submitted for each delegated provider who renders a service. Each provider may only use one modifier per line.

Claims for any date of service submitted without a modifier or submitted with two or more of these modifiers on the same detail will be denied.

For more information, call the TMHP Contact Center at 800-925-9126.