CommercialBilling CodesMedium impact
25-607 Use Correct CPT Codes and Modifiers When Billing for Mobile Crisis Services
Health Net·CA · Psychiatry·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net California requires specific CPT codes, HIPAA modifiers, and Place of Service 15 (Mobile Unit) for behavioral health mobile crisis services to receive in-network reimbursement rates. Claims not using the specified codes and modifiers will apply standard out-of-network benefits and cost sharing.
Action Required
Immediately: Billing team must update system to require Place of Service 15 (Mobile Unit) for all behavioral health mobile crisis claims. Use only the specified CPT/HCPCS codes (H0007, H0030, H0018, H2011, H2017, T1017, S9484, S9485, 90791, 90792, 90839, 90840, G0017, G0018, G0544, G0560) and appropriate HIPAA modifiers based on provider licensure. Train staff that claims without proper codes/modifiers will process at out-of-network rates with higher patient cost sharing.