News

Medicaid QTT Notification

Date: 07/12/2017

Dear Provider,

The Forward Health website states  that services  rendered by the two(2) types of qualified treatment trainees (QTTs) defined in DHS 35.03(17m), Wis. Admin. Code, are billable by a Medicaid-enrolled outpatient mental health clinic. Since 2015, Cenpatico has accepted services rendered by Master’s-Level QTTs working on their supervised practice requirements/hours for full clinical licensure. The professional billing modifier U6 is required on these claims and the Master’s-level QTTs must be credentialed with Cenpatico. For additional information, please review Cenpatico Notification from February, 2015 at www.cenpatico.com.

Cenpatico will now also accept services rendered by QTTs who are graduate students doing their practicum. Graduate Student-Level QTTs, as defined in DHS 35.03(17m), Wis. Admin. Code, are QTTs who meet both of the following criteria:

• They are graduate students at an accredited institution and enrolled in psychology, counseling, marriage and family therapy, social work, nursing, or a closely related field.

• They are doing a supervised practicum for their graduate degree program in a Medicaid-enrolled outpatient mental health clinic.

Services rendered by graduate students doing their practicum are reimbursable as specified in DHS 107.01(2), Wis. Admin. Code. Qualified Treatment Trainees who are graduate students may not be Medicaid enrolled as QTTs during their practicum. Graduate students doing their practicum are required to follow all supervision requirements outlined in DHS 107.01(2), Wis. Admin. Code. Graduate Student-Level QTTs services are required to be bill under their supervisor’s name, National Provider Identifier (NPI) and Taxonomy as the rendering provider, with the service modifier U7 indicating that a student rendered the services (the service modifier U7should be included in addition to the supervisor’s professional billing modifier).

Claims for services rendered by graduate students doing their practicum are reimbursed at the supervisor’s reimbursement rate. Per DHS 107.01(2)(c), Wis. Admin. Code, the student does not bill and is not reimbursed directly for his or her services. Services rendered by a QTT are subject to the same outpatient prior authorization requirements as Cenpatico Participating Providers.

Sincerely,

Cenpatico Provider Relations