I received notification that codes H0031 & H0032 will only be able to be billed as 1 unit and must have the modifier "UD" removed as of 01/01/2019.  MHCP posted a bulletin about these changes:

"The Centers for Medicare & Medicaid Services (CMS) has established a Medically Unlikely Edits (MUEs) of one unit for HCPC codes H0031 (mental health assessment by non-physician) and H0032 (mental health service plan development by non-physician) beginning Jan. 1, 2019. MUEs prevent payment for an inappropriate quantity of the same service on a single day. Currently, more than one unit is allowed for each of these codes when the UD modifier is included. The UD modifier will no longer be required and only one unit of each of these services will be allowed per day for Managed Care Organizations (MCOs) and fee-for-service claims beginning Jan. 1, 2019. Minnesota Health Care Programs (MHCP) will deny a claim line that includes more than one unit. MHCP will determine a per-session rate for H0031 and H0032 and will reprocess paid claims with dates of service beginning Jan. 1, 2019, once a new rate is established. (pub. 12/28/18, rev. 1/8/19)"

Since our claims are currently being denied, I contacted MN-ITS provider help desk to inquire about this.  Essentially they have no answer as to when the rate for 1 unit will be decided, or what that rate will be.

Has anyone come up with a decent conclusion how to bill for these properly?  Provider help desk did say they will automatically resubmit all claims that contain 1 unit.

Thanks in advance

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Good morning,

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Sheryl