MedicaidBilling CodesMedium impact
MAB2020091502
Pennsylvania Medicaid (DHS)·PA · Psychiatry·Provider Bulletin
Effective date
Sep 15, 2020
We identified it
Jun 20, 2026
Summary
Pennsylvania FQHCs and RHCs must now add the HQ modifier to procedure code T1015 when billing for behavioral health group therapy encounters. This change allows proper identification and payment for group therapy services provided by qualified mental health professionals.
Action Required
Immediately: Billing team must update system to add HQ modifier to T1015 for all behavioral health group therapy encounters at FQHCs and RHCs. Also include HE (mental health program) or HF (substance abuse program) informational modifiers as applicable. Only bill when group therapy is led by qualified professionals: psychiatrists, licensed clinical psychologists, licensed clinical social workers, licensed professional counselors, or licensed marriage and family therapists.