BH Crisis Evaluation (Required of Hospitals)
On initial day of readiness (S9485, no modifier)
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ED-Based |
Med/Surg |
|---|---|
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S9485 should be used for crisis interventional mental health services, per diem.
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S9485 should be used for crisis interventional mental health services, per diem. |
BH Crisis Management
On days subsequent to the initial BH Crisis Evaluation for individuals experiencing a behavioral health crisis in need of ongoing behavioral health crisis supports (S9485-V1 or -V2)
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ED-Based |
Med/Surg |
|---|---|
|
S9485 with a V1 or V2 modifier should be billed no more than one unit per day. Modifier V1 should be used for the provision of BH Crisis Management Services, in accordance with Operational Standards for BH Crisis Management Services for members requiring ongoing safety monitoring without the need for active safety interventions on the billing calendar day. Modifier V2 should be used for the provision of BH Crisis Management Services, in accordance with Operational Standards for BH Crisis Management Services for members requiring active staff safety monitoring and intervention to prevent, or respond to, attempts of self-injury or aggression in the hospital on the billing calendar day (i.e, arms-length 1:1 safety observation or interventions of equal or higher intensity). |
S9485 with a V1 or V2 modifier should be billed no more than one unit per day. Modifier V1 should be used for the provision of BH Crisis Management Services, in accordance with Operational Standards for BH Crisis Management Services for members requiring ongoing safety monitoring without the need for active safety interventions on the billing calendar day. Modifier V2 should be used for the provision of BH Crisis Management Services, in accordance with Operational Standards for BH Crisis Management Services for members requiring active staff safety monitoring and intervention to prevent, or respond to, attempts of self-injury or aggression in the hospital on the billing calendar day (i.e, arms-length 1:1 safety observation or interventions of equal or higher intensity). |
MOUD Induction
For initiation of medication for opioid use disorder in the emergency department for MassHealth members who consent to initiation (G2213)
| Ed- Based Only |
|---|
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The G2213 add-on code can be billed for initiating buprenorphine in the ED for individuals who have signs or symptoms of untreated opioid use disorder. The G2213 add-on code must be billed in addition to evaluation and management in the ED setting of the patient’s presenting condition.
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Recovery Support Navigator (RSN)
RSN services provided in the emergency department or medical/surgical floors (H2015-HF)
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ED-Based |
Med/Surg |
|---|---|
|
H2015-HF is billable in the ED setting. |
H2015-HF is billable in the medical/surgical setting. |
| Date published: | April 30, 2024 |
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