April 24, 2025
Following are this week’s updates. If you have questions, please contact ehr@calmhsa.org.
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Updated Terms of Service for Prescribers
Surescripts, the national clearinghouse employed by prescribing software to transmit prescription information to and from pharmacies (both Medication Rx and CalMHSA Rx employ this functionality) has recently updated its Terms of Service (TOS). Because CalMHSA’s legal counsel has advised it is important that all prescribers are informed of this update, we have created a splash screen at log-in, where staff will be presented with the new TOS and can review and acknowledge them.
The updated Terms of Service are also available in their entirety on the website.
All staff will encounter the log-in message, as functionality doesn’t allow it to be shown only to prescribers. The beginning line of the notice indicates this only pertains to prescribers, and the expectation is that they — prescribers and prescriber support staff — will review the new TOS and click the “acknowledge” button.
If they prefer to review at a different time, they may also click the “later” button, and the log in message will display when they log in again. Non-prescribers can simply click the acknowledge button, and the message will disappear; they do not need to review.
This feature is available in the “Land page messages” screen in SmartCare. Instructions
CalMHSA plans to enable this on May 15 and can enter this into counties’ system or counties can enter it on their if they prefer. Please contact ehr@calmhsa.org if you have any questions or concerns.
Revisions to Invoice Generator
New versions of the Invoice Generators have been published to CalMHSA’s website and contain the following updates:
Rate Calculation for Crisis Procedures
Previously, the encounter rate for mobile crisis listed on the Other Rates tab could be selected for Crisis Intervention or Crisis Inquiry services if the location of the service was Mobile Unit. The logic has been revised to ensure that the encounter rate for mobile crisis is used only when the service is linked to Mobile Crisis Encounter (Procedure Code ID 303), and the location is either Mobile Unit or Mobile Unit with Telehealth. Crisis Intervention and Crisis Inquiry, or Mobile Crisis Encounter performed at a location other than Mobile Unit or Mobile Unit with Telehealth, will pull the rate associated with H2011 on the Outpatient Rates tab.
Accommodation of T2021 and T2024 for Medicare and Commercial Payers
During the 2024-25 fiscal year, the Department of Health Care Services (DHCS) revised its billing guidance on how to extend non-E&M therapy service codes by introducing substitute therapy codes of T2021 and T2024. These ‘T codes’ allow clinicians to be reimbursed for the total time spent with a client by incrementing for every 15 minutes beyond the max allowed time allowed for the CPT code.
The Invoice Generator is designed to pull the initial charge associated with a service into the Contract Provider Charge Export. This logic may result in contractors being underpaid for this subset of billing codes if the charge appearing in the export is for one of these codes, the payer tied to the charge is Medicare or an OHC plan, and the service duration exceeds the allowed minutes associated with the CPT code.
To address this issue, CalMHSA has implemented changes to the Invoice Generator. Details can be found in this knowledge base article.
Problem List Changes
With the deployment of the December and January MSPs, counties may notice that the Client Clinical Problem List now has ICD-10 code descriptions. This was a change that CalMHSA requested due to a few factors.
First, when the ICD-10 code did not have a corresponding SNOMED code, the description was blank. Including the ICD-10 code description addresses that issue. Additionally, counties prefer not to choose a SNOMED code that would be the description on the Problem List, as Behavioral Health uses ICD-10, not SNOMED. The recent change resolves this by showing the ICD-10 code description alongside the SNOMED code when viewing the Client Clinical Problem list, and changing the description in the Progress Note from the SNOMED description to the ICD-10 code description.
Service Authorization Q&A Follow-Up
For those who attended the Service Authorization Q&A on Tuesday, April 8th, or anyone who missed it, the CalMHSA EHR Team has shared helpful resources and clarifications:
Meeting Recording & Deck: The recording of the Q&A session is available here (Passcode: rX*3f85+). The presentation deck was also shared (please refer to the original email for the attachment).
- Care Coordination Setup: It was confirmed that a configuration key must be enabled for certain Care Coordination program fields. A new knowledge base article detailing the basic setup is now available: Care Coordination Basic Setup.
- Previous Demo Recording: The link for the original Service Request process demonstration has been fixed. You can access it here: Previous Demonstration Recording (Password: @n.=bLs0)
- Known Issues: The known issue section of the Service Authorization web page has been updated to include all of the issues brought up during the meeting. Service Authorizations – 2023 CalMHSA
- Follow-Up with Streamline: Regarding the status of the filter logic fix and several enhancement requests, including a global view of requests, updated requester widget statuses, and a simplified reviewer workflow.
- We will be addressing the gap regarding receiving provider visibility. We will explore solutions with streamline alongside our privacy counsel.
Given the the feedback received by counties we will be re-evaluating the discussed July 1st cutover date of the Authorization tracking document.Please reach out to the CalMHSA EHR Team if you have further questions.
This Week’s Production Updates
New functionality in the EHR – and what you need to know about it – is available here.