KMAP BULLETIN: Mental Health/Autism Codes
Date: 12/17/18
KMAP GENERAL BULLETIN 18259 (PDF)
Effective December 31, 2018, the procedure codes referenced in the tables below will be end-dated. Effective January 1, 2019, the corresponding replacement and add-on codes and rates referenced in the tables below will be available.
Base Codes
| Codes Ending 12/31/2018 | Codes Effective 01/01/2019 | Code Rates Effective 01/01/2019 |
|---|---|---|
| 96101 | 96130* | $76.00 per hour |
| 96118 | 96132* | $102.00 per hour |
| 96118 | 96136* | $51.00 per 30 minutes |
| 96119 | 96138* | $29 per 30 minutes |
| 96103 | 96146 | $26.00 per session |
| 0359T | 97151 | $17.50 per 15 minutes |
| 0360T | 97152 | $17.50 per 15 minutes |
| 0364T | 97153 | $6.25 per 15 minutes |
| 0368T | 97155 | $17.50 per 15 minutes |
| 0370T | 97156 | $17.50 per 15 minutes |
*Reference the Add-on Codes table below.
Add-on Codes**
| Codes Ending 12/31/2018 | Codes Effective 01/01/2019 | Code Rates Effective 01/01/2019 |
|---|---|---|
| 96101 | 96131 for 96130 | $76.00 per hour |
| 96118 | 96133 for 96132 | $102.00 per hour |
| 96118 | 96137 for 96136 | $51.00 per 30 minutes |
| 96119 | 96139 for 96138 | $29 per 30 minutes |
**Additional add-on code: 96121 for 96116 at $85.56 per hour.
Reference General Bulletin 18237 for additional 2019 HCPCS updates and information.
Note: The effective date of the policy is January 1, 2019. 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.
Note: Refer to the CPT® codebook for complete descriptions. This may not be an all-inclusive list of HCPCS 2019 updates. CPT codes, descriptors, and other data only are copyright 2018 American Medical Association (or such other date of publication of CPT). All rights reserved. Applicable FARS/DFARS apply. Information is available on the American Medical Association website.