Clinical Social Work Practice Tools: Billing

With the emergence of the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) has temporarily expanded its telehealth policies on an emergency basis under the 1135 waiver authority and the Coronavirus Preparedness and Response Supplemental Appropriations Act.

The Centers for Medicare and Medicaid Services announced on April 3, 2020, revisions for telehealth place of service (POS) and modifier codes. The revisions will allow clinical social workers (CSWs) to be reimbursed at the samerate as an in-person service.

Beginning January 1, 2020, new Health Behavior Assessment and Intervention (HBAI) Current Procedural Terminology (CPT) Codes were implemented.

An increasing number of clinical social workers have reported to NASW that paper claims submitted on the CMS-1500 form are being denied because boxes 14 and 15 were not completed.

Effective October 1, 2018, several code changes to the International Classification of Diseases-10-Edition-Clinical Modification (ICD-10-CM), will be implemented by the National Center for Health Statistics, a federal agency who created the files under the authorization of the World Health Organization.

In 2013, 90837 was one of several psychotherapy procedural codes introduced to health care professionals such as clinical social workers and the health insurance industry.