To obtain accurate and up-to-date information regarding ChampVA billing codes, condition codes, occurrence codes, and value codes for behavioral health RTC, PHP, and IOP claims. It can be best to consult the official resources provided by ChampVA.
Every plan is different, and they can provide you with the most current and accurate information related to their billing and coding requirements.
What are the ChampVA Billing Codes for Behavioral Health
ChampVA follows the standard coding systems for billing behavioral health services. The most commonly used coding systems for behavioral health services are the Current Procedural Terminology (CPT) codes and the Healthcare Common Procedure Coding System (HCPCS) codes. Here are some common CPT and HCPCS codes that may be used for billing behavioral health services with ChampVA:
CPT Codes:
- 90791: Psychiatric diagnostic evaluation
- 90832: Individual psychotherapy, 30 minutes
- 90834: Individual psychotherapy, 45 minutes
- 90837: Individual psychotherapy, 60 minutes
- 90846: Family psychotherapy without the patient present
- 90847: Family psychotherapy with the patient present
- 90853: Group psychotherapy
- 96101: Psychological testing evaluation services
- 96118: Neuropsychological testing
- 99213: Evaluation and management (E/M) service for an established patient, 15 minutes
HCPCS Codes:
- H0031: Mental health assessment, by a non-physician
- H0035: Partial hospitalization (PHP) services, per diem
- H0036: Community-based psychiatric rehabilitation and support, per 15 minutes
- H2011: Crisis intervention, per hour
- H2035: Alcohol and/or drug services, group counseling
- H0004: Behavioral health counseling and therapy, per 15 minutes
- S9484: Behavioral health, counseling and/or therapy provided via synchronous telecommunication
- T1015: Mental health case management
The specific codes used for billing behavioral health services may vary depending on the nature of the service provided, the duration, the level of care, and other factors. Consult the most recent version of the ChampVA provider manual or contact ChampVA directly for the most accurate and up-to-date information on billing codes specific to their program.
How to become credentialed with ChampVA as a healthcare provider?
Providers need to go through a credentialing process. Here are the general steps involved:
- Determine eligibility: First, ensure that you meet the eligibility criteria to participate as a provider in the ChampVA program. This typically involves having the necessary licenses, certifications, and qualifications to provide the specific healthcare services covered by ChampVA.
- Complete the application: Obtain the provider application form from ChampVA. You can typically find the application form on their official website or by contacting their provider enrollment department. Fill out the application form accurately and completely, providing all the required information.
- Gather required documentation: Along with the application form, you will need to submit various supporting documents. These may include proof of your professional qualifications, such as copies of licenses, certifications, and educational degrees. You may also need to provide documentation related to your professional liability insurance, practice locations, and other relevant details.
- Submit the application: Once you have completed the application and gathered the necessary documentation, submit the application and supporting documents to ChampVA according to their specified instructions. This is typically done either electronically or by mail, depending on their preferred method.
- Follow up and respond to inquiries: After submitting your application, be prepared to respond to any additional requests for information or clarifications from ChampVA. They may contact you if they require any further documentation or have questions regarding your application.
- Await review and decision: The ChampVA provider enrollment department will review your application, verifying your credentials and evaluating your eligibility to participate in the program. The review process can take some time, so it’s important to be patient.
- Notification of credentialing decision: Once the review process is complete, you will receive a notification from ChampVA regarding the status of your credentialing application. If approved, you will be provided with further instructions on the next steps to become an enrolled provider with ChampVA.
Specific requirements and processes for credentialing with ChampVA can be dependent on each provider. Providers can also contact the enrollment department directly to obtain the most accurate and up-to-date information on their credentialing process and any specific requirements they may have.