Payment for MFTs and MHCs in a Method II CAH

Related CR Release Date: January 25, 2024
Effective Date: January 1, 2024
Implementation Date: February 26, 2024 - (for requirements implementation date)
Related Change Request (CR) Number: CR 13502
Related CR Transmittal Number: R12477CP

CR 13502 establish payment instructions for Marriage and Family Therapists and Mental Health Counselors, as authorized by Section 4121 of the Consolidated Appropriations Act, 2023.

Physicians and non-physician practitioners billing on Type of Bill (TOB) 85X for professional services rendered in a Method II CAH have the option of reassigning their billing rights to the Critical Access Hospital (CAH). When the billing rights are reassigned to the Method II CAH, payment is made to the CAH for professional services (Revenue Codes (RC) 96X, 97X or 98X). Medicare makes payment for Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs) to a Method II CAH is 80 percent of the lesser of the actual charge for the services or 75 percent of the Medicare Physician Fee Schedule (MPFS).

Make sure your billing staff knows about these changes.

View the complete CMS Change Request (CR)13502.

Last Updated Feb 02 , 2024