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Elizabeth M. Whitehorn, Director

Provider Notice issued 12/05/2024

 

To:  Community Mental Health Providers, Behavioral Health Clinics, Licensed Clinical Psychologists, Licensed Clinical Social Workers, Licensed Clinical Professional Counselors, and Licensed Marriage and Family Therapists
​Date December 5, 2024
​Re:
 Telehealth Billing System Issue Resolutions and Billing Guidance

This notice informs providers of resolution to a telehealth duplicate rejection system issue. Programming updates were implemented November 14, 2024, to fix the system issue causing telehealth claims to reject as duplicate (D01 error code) when multiple services were billed with differing telehealth modifiers and/or places of service. This system issue affected only fee-for-service (FFS) claims and not managed care organization (MCO) claims.

Beginning with dates of service October 1, 2021, providers were instructed to begin utilizing telehealth modifiers and places of service to specify telehealth delivery mode in accordance with the September 1, 2021 provider notice. A system issue was identified and believed to have been resolved, with providers given rebilling instructions in the January 9, 2023 provider notice.  However, that system issue persisted for certain telehealth claims and was finally resolved November 14, 2024. 

Telehealth services that rejected as duplicate dating back to October 1, 2021, should now be rebilled, with a request for timely filing override as needed.

Providers may direct questions to a community mental health center billing consultant in the Bureau of Professional and Ancillary Services at 877-782-5565, option sequence 1, 2, 4, then 8.  Providers needing only to request a timely filing override may submit their claim(s) electronically with the HFS 1624 Override Request Form as an electronic attachment.

 

Kelly Cunningham, Administrator
Division of Medical Programs