Billing FFPSA Using the HV Modifier

BHIN 21-062 provides directions on how to claim for Family First Prevention Services Act (FFPSA) services. There are two instances that when counties can bill for services:

  1. Services provided by a Qualified Individual, which includes:
    1. Assessment (90791)
    2. Plan Development (H0032)
    3. Intensive Care Coordination (T1017)
  2. Aftercare services

Other services provided to a client while they are placed in an STRTP do not get the HV modifier. Because of this, we are not pursuing a special population to add the HV modifier. Instead, CalMHSA is recommending counties identify these clients based on programs. If not already done so, we recommend creating the following programs (your naming conventions may vary):

  1. FFPSA Qualified Individual program
  2. FFPSA Aftercare Wraparound program

The QI program should only include the following procedure codes. Other procedures are not associated with Assessment, Plan Development, or Intensive Care Coordination, and therefore should not include the HV modifier.

  1. Assessment LPHA
  2. Plan Development, non-physician
  3. TCM/ICC

The Aftercare program must comply with California Wraparound Service Standards. Wraparound does include many procedure codes. Any that can have the HV modifier can be added to this program.

Make sure rates for these programs are setup to include the appropriate modifier, HV, along with any other modifiers, such as HK when providing ICC. 

Please feel free to reach out to CalMHSA if you need assistance in implementing this in your county’s instance of SmartCare.

Updated 11/3/23