In-Home Psychotherapy Reimbursement Update for Non-Physicians

Date: 09/24/24

Effective January 1, 2025, Superior HealthPlan will discontinue an extra-contractual travel expense rate addition for in-home behavioral health therapy. The rate addition was a supplement for providers who were required to travel long distances to a patient’s home to provide medically necessary behavioral health therapy services for the convenience of a member/patient that was either unable or unwilling to travel to the provider’s office site for services. With the expansion of telehealth and telemedicine by the Texas legislature, this rate adjustment is no longer needed.     

Psychotherapy services delivered in the patient’s home will be reimbursed according to the Participating Provider’s Contract and the Medicaid fee schedule reimbursement rates for the applicable procedure codes listed in the table below.

Procedure Code	Code Description
90791	Psych Eval
90792	Psych Eval with Med Services
90832	Psychotherapy 30 mins
90834	Psychotherapy 45 mins
90837	Psychotherapy 60 mins
90846	Group Therapy without Patient
90847	Group Therapy with Patient

 

Superior appreciates the provision of covered services to our enrolled member population and the continued cooperation of its contracted network of providers.

If you have questions related to the information in this notice, please contact your Account Management representative at: AM.BH@SuperiorHealthPlan.com