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PMAP

Leah T. 2 years ago in Codes/Rates/Diagnosis Modules updated 1 year ago 3

Can we bill UA codes for NON CTSS clients if they have PMAP insurance?

The UA modifier means it is a rehab service.  So it would not be appropriate to bill rehab services for non rehab clients unless you can document the need for the change.

The way I understand it, if the CTSS recommendation is not in the DA, and you are not a CTSS certified agency, then you will get denials if you bill UA codes. The DHS site defines CTSS as restorative rehabilitative services, as tbelcher notes above. This is from their site:

Children’s Therapeutic Services and Supports (CTSS)

Children’s Therapeutic Services and Supports (CTSS) are a set mental health services developed to provide restorative rehabilitative interventions covered by Minnesota Health Care Programs (MHCP) to children and their families. CTSS establishes policies and practices for certification and coverage of mental health services for children who require varying therapeutic and rehabilitative levels of intervention in their homes or elsewhere in the community.

Children’s Therapeutic Services and Supports (CTSS) components may be provided only by an agency (county, tribe or non-county agency) or a school that has been certified using the provider certification process developed by DHS.

Ok thank you. We are a CTSS certified agency and we bill UA modifier with our CTSS codes, our therapist was just wondering if those UA modifiers could go on other services provided for clients that aren't considered CTSS but it sounds like the answer would be no.