HCPCS codes are required on all claims for crisis intervention services. Claims or adjustments received without a HCPCS code are denied. Providers should refer to the mental health and substance abuse maximum allowable fee schedule for maximum allowable fees and copayment rates.
For procedure codes that do not indicate a time increment, providers are required to use the rounding guidelines which are available.
The following table lists the HCPCS code, modifier, and "V" code that providers are required to use when submitting claims for crisis intervention services. "V" codes describe circumstances that do not lend themselves to diagnosis. "V" codes from the ICD-9-CM coding structure, rather than diagnosis codes, must be used for submitting claims for crisis intervention services. Claims received without a current ICD-9-CM "V" code are denied. Do not use diagnosis codes, including mental health and substance abuse codes, when submitting claims.
Submitted Only on the 1500 Health Insurance Claim Form
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Procedure Code Information for Crisis Intervention Services |
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| HCPCS Code | Description | Professional Level Modifier | Allowable ICD-9-CM Codes | Telehealth Services Covered? | ||
| S9484 | Crisis intervention mental health services, per hour | UA | V40.0-V40.9, V41.0-V41.9 V60.0-V60.9, V61.0-V61.9* V62.0-V62.9, V65.0-V65.9* V69.0-V69.9, V71.0-V71.9* |
Yes (use GT modifier) |
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| UB | ||||||
| HP | ||||||
| HN | ||||||
| HO | ||||||
| U7 | ||||||
| S9485 | Crisis intervention mental health services, per diem | None | V40.0-V40.9, V41.0-V41.9 V60.0-V60.9, V61.0-V61.9* V62.0-V62.9, V65.0-V65.9* V69.0-V69.9, V71.0-V71.9* | No | ||
| * | Some of the condition codes in this category require a fifth digit. Refer to ICD-9-CM for more information. |