Claims Reminders for Behavioral Health Services
AI Summary
Blue Cross Blue Shield of Texas issued reminders for behavioral health billing emphasizing that out-of-network providers must bill under their own NPI (not pass-through billing), trainees must have direct supervision 100% of the time, and a future HL modifier will be required for trainee services. These same requirements apply to physical health services.
Action Required
Immediately: Review current billing practices to ensure out-of-network providers in group practices bill under their own NPI, not the supervising provider's NPI. Verify all trainee services have 100% direct supervision documented. Prepare for future HL modifier implementation for trainee services (do not use until BCBSTX notification). Update documentation to support direct supervision requirements.
Plan Types
All Plans
States
TX
Specialties
psychiatry, family-medicine, internal-medicine, pediatrics