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July 3, 2006
 
 
 
MEDICAID INFORMATION RELEASE MA06-24
 
TO:                   Developmental Disabilities Agencies (DDA)
 
FROM:             Leslie M. Clement, Administrator
 
SUBJECT:       NEW DDA PROCEDURE CODES EFFECTIVE JULY 1, 2006
 
Beginning July 1, 2006, DDAs may bill for Pharmacological Management and a Comprehensive Intensive Behavioral Intervention (IBI) Assessment when provided in accordance with IDAPA 16.04.11, “Developmental Disabilities Agencies (DDA)”.  These services will be subject to current DDA limitations and the limitations outlined in IDAPA 16.03.10, “Medicaid Enhanced Plan Benefits” that will be published in the August edition of the Idaho Administrative Bulletin.
 
These services will be as follows:
 
Service
CPT or HCPCS Code
Description
Place of Service
Rate
Pharmacological Management
90862
Pharmacologic management, including prescription use, and review of medication with no more than minimal medical psychotherapy.
 
1 unit = 1 visit
11 – Office
 
12 – Home
 
99 – Other
$50.26/visit
Comprehensive IBI Assessment
T2024
Service Assessment.
 
Specify exact time.
 
1 unit = 15 minutes
 
PA required
11 – Office
 
12 – Home
 
99 – Other
$11.35/unit
 
The Department is continuing to work on developing an additional DDA service called Supportive Counseling.  Further information will be provided as it becomes available through a separate Information Release and in the August edition of the Idaho Administrative Bulletin.
 
If you have questions regarding this information, please contact David Simnitt in the Bureau of Behavioral Health at (208) 364-1992.  Thank you for your continued participation in the Idaho Medicaid program.
 
IDAHO MEDICAID PROVIDER HANDBOOK
This Information Release updates Section 3.3 of your Idaho Medicaid Provider Handbook – Rehabilitative and Health Related Services Guidelines.
 
LMC/ds/sw