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How to Setup Mobile Crisis Procedure Rates

Current "Crisis Intervention/Mobile Crisis" Procedure Code

On 1/1/24, CalMHSA will be changing the name of the procedure code “Crisis Intervention/Mobile Crisis” to simply “Crisis Intervention”. This will allow users to continue to use the regular progress note and procedure code for non-Mobile Crisis related crisis intervention services. Counties will have to end-date any “Mobile Crisis” versions of these rates. Mobile Crisis services will be billed using the new procedure code, “Mobile Crisis Encounter”.

Rate Setup for "Mobile Crisis Encounter" Procedure Code

CalMHSA has created new procedure codes. Only one of these is billable: “Mobile Crisis Encounter”. Counties will need to add rates for this code. 5 rates will need to be created to address the following 5 scenarios:

  1. Service is identified as SMHS and both providers were on-site
  2. Service is identified as SMHS and one provider was on-site and the other provider was telehealth
  3. Service is identified as DMC and both providers were on-site
  4. Service is identified as DMC and one provider was on-site and the other provider was telehealth
  5. Service uses a location other than an approved one, resulting in a $0 rate (rule-out condition)

Scenarios 3 & 4 will vary depending on whether you’re a DMC-ODS county or a DMC State Plan county.

All use the H2011 code, but the modifiers change depending on the scenario.

  1. Service is identified as SMHS and both providers were on-site
    • Requires “HE” modifier; Location must be “Mobile Unit”; Service area must be “MH”
  1. Service is identified as SMHS and one provider was on-site and the other provider was telehealth
    • Requires “HE” and “GT” modifiers; Location must be “Mobile Unit with Telehealth”; Service area must be “MH”
  1. DMC-ODS: Service is identified as DMC and both providers were on-site
    • Requires “U” modifier; Location must be “Mobile Unit”; Service area must be “DMC”
  1. DMC-State Plan: Service is identified as DMC and both providers were on-site
    • No modifier; Location must be “Mobile Unit”; Service area must be “DMC”
  1. DMC-ODS: Service is identified as DMC and one provider was on-site and the other provider was telehealth
    • Requires “U” and “GT” modifiers; Location must be “Mobile Unit with Telehealth”; Service area must be “DMC”
  1. DMC-State Plan: Service is identified as DMC and one provider was on-site and the other provider was telehealth
    • Requires “GT” modifier; Location must be “Mobile Unit with Telehealth”; Service area must be “DMC”
  1. Service uses a location other than an approved one, resulting in a $0 rate (rule-out condition)
    • Location must be anything except “Mobile Unit” or “Mobile Unit with Telehealth”; Charge must be $0

Updated 12/22/23