KMAP BULLETIN: Clarification on Age Ranges and Telemedicine Coverage with H0036 and H2017 Codes

Date: 10/30/20

KMAP GENERAL BULLETIN 20214 (PDF)

Effective for dates of service on and after November 16, 2020, the age range for code H0036 HA (Community Psychiatric Supportive Treatment, Child/Youth), will be established as ages 0-21. The code of H0036 HB (Community Psychiatric Supportive Treatment, Adult) should continue for the age range of 16-99.

The age range for code H2017 TJ (Psychosocial Rehabilitation, Child/Youth, Group), will be established for ages 0-21. The code of H2017 HQ (Psychosocial Rehabilitation, Adult, Group) should continue for the age range of 16-99.

For either of these two services, if clinical reasons are present that support an individual under the age of 4 or over the age of 18 would benefit from services provided as an individual or in a group setting utilizing “child/youth” services, billing justification for this clinical decision should be documented in the medical record. If an individual 18 years of age or under would benefit from services provided as an individual or in a group setting utilizing adult services, this clinical decision should likewise be documented in the medical record.

Existing modifiers currently attached to either the H0036 or H2017 codes are intended to be allowed via telemedicine until that allowance is specifically rescinded.

Note: The effective date of the policy is November 16, 2020. The implementation of State policy by the KanCare managed care organizations (MCOs) may vary from the date noted in the Kansas Medical Assistance Program (KMAP) bulletins. The KanCare Open Claims Resolution Log on the KMAP Bulletins page documents the MCO system status for policy implementation and any associated reprocessing completion dates, once the policy is implemented.