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How to Create Authorization Codes

Authorization Codes are basically a group of procedure codes that are authorized together as a bundle. They all use the same reservoir of authorized units, meaning that if there are 60 units authorized, any procedure codes that are part of this authorization bundle will dip into those 60 units. It’s not 60 units per procedure code that’s included in the bundle; it’s 60 units per authorization bundle.

  1. Navigate to the Authorization Codes list page.
    1. Click the Search icon.
    2. Type “Authorization Codes” in the search bar.
    3. Click to select “Authorization Codes (Administration)” from the search results.
  1. Click the New icon to create a new code.
    1. Alternatively, you can click on the link in the Auth ID column to modify an existing code.
  1. In the Code Information section:
    1. Enter the name of the code. Clicking tab will automatically populate the “Display As” field with the same information in the “Code” field. You may make changes to the “Display As” field if necessary.
    2. By default, the “Active” checkbox will be checked.
    3. Select the units for this code.
      1. The second field is a dropdown that is the unit of measurement, such as “minutes” or “days”. This must match the unit of measurement for any procedure codes you will be adding to this Authorization Code. For example, if the procedure code is measured in minutes, you cannot select “hours” for the authorization code measurement unit.
      2. The first field allows you to determine how many of those measurement units will be the unit for this authorization code. For example, if you enter “1 Minutes” then you will have to authorize by minutes in the authorization screen. If you would like to authorize by the hour for a procedure code measured in minutes, enter “60” in the Unit field, which should allow you to authorize 60 minutes at a time. Note that by doing so, services will have to use 1 unit at a time. For example, if you put 1 unit = 60 minutes, if a service is 40 minutes, it will either round up to 1 unit (based on a config key) OR not use this authorization, since it hasn’t reached the threshold of a single unit (under 60 minutes). We recommend using a 1:1 unit-to-measurement ratio.
    4. Check the “External” checkbox. “Internal” uses treatment plan functionality in SmartCare that CalMHSA is not using.
  2. In the Associated Procedure Codes section, click Add.
  1. This will bring up the Practice Management Code popup window. Select all the procedure codes that will be authorized as part of this authorization code and click OK.
  1. This takes you back to the Authorization Code Details screen where you can now see the procedures you’ve selected in the Associated Procedure Codes section. Ignore the Care Management section and the Code Categories section, as these are for functionality that CalMHSA does not use. Click Save.

Updated 12/5/24