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CMS-1403-FC
clinical treatment for these disorders. As we stated in
the CY 2008 PFS final rule with comment period, we believe
that for purposes of providing care in a CORF, social and
psychological services should represent only case
management and patient assessment components as they relate
to the rehabilitation treatment plan (72 FR 66297 through
66298). Consequently, after notice and comment, we changed
our policy and payment for CORF social and psychological
services; these services may no longer address a CORF
patient’s mental health diagnoses except insofar as they
relate directly to other services provided by the CORF.
We specified in the CY 2008 final rule with comment
period (72 FR 66298) that only the CPT code 96152 for
health and behavior intervention (with the patient) could
be used to bill for CORF social and psychological services.
This code was part of a series of codes that was created by
CPT in 2002 to address health and behavior assessment
issues. These services are offered to patients who present
with established illnesses or symptoms, who are not
diagnosed with mental illness, and may benefit from
evaluations that focus on the biopsychosocial factors
related to the patient’s physical health status, such as
patient adherence to medical treatment, symptom management
and expression, health-promoting behaviors, health-related
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