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Coverage of 99211 by Registered Nurse Employed by CMHC

Date: 01/18/2017

Effective with dates of service on and after February 1, 2017, services billed using procedure code 99211, and provided by a Registered Nurse employed by a CMHC, are eligible for reimbursement.

When the CMHC is billing for 99211 rendered by an RN, modifier TD should be appended to the code. Reimbursement will be at 75% of the Medicaid rate. The CMHC National Provider Identifier (NPI) or Kansas Medical Assistance Program (KMAP) provider ID number should be used as both the billing and performing provider.

The provisions of billing for an Evaluation and Management (E&M) code should be followed. If the service is found not to be in compliance with correct coding guidance, the service would be subject to recoupment upon auditing.

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