This section establishes physician payment methodology and reimbursement rates for behavioral health services rendered under the Louisiana Behavioral Health Partnership (LBHP) Medicaid program. It sets rates as a percentage of the Louisiana Medicare Region 99 allowable and specifies that certain CPT procedure codes (psychiatric evaluation and psychotherapy codes) are excluded from 2013 Medicare rate changes. Facility operators billing physician services under LBHP must follow the flat-fee Medicaid fee schedule as described.
View official sourceSubpart 2. General Provisions Chapter 17.Behavioral Health Services Reimbursements §1701.Physician Payment Methodology A.The reimbursement rates for physician services rendered under the Louisiana Behavioral Health Partnership (LBHP) shall be a flat fee for each covered service as specified on the established Medicaid fee schedule. The reimbursement rates shall be based on a percentage of the Louisiana Medicare Region 99 allowable for a specified year. B.Effective for dates of service on or after April 20, 2013, the reimbursement for behavioral health services rendered by a physician under the LBHP shall be 75 percent of the 2009 Louisiana Medicare Region 99 allowable for services rendered to Medicaid recipients. C.Effective for dates of service on or after September 1, 2013, the reimbursement for procedure codes 90791, 90792, 90832, 90834 and 90837 shall be excluded from the January 2013 Medicare rate changes and shall remain at the Medicaid fee schedule on file as of December 31, 2012. AUTHORITY NOTE:Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act. HISTORICAL NOTE:Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing and the Office of Behavioral Health, LR 40:1697 (September 2014), amended LR 40:1935 (October 2014).