Notice: This CMS-approved document has been submitted - Philips ...

CMS-1403-FC
psychological services include the assessment and treatment
of a CORF patient’s mental health and emotional functioning
and the patient’s response to/and rate of improvement and
progress towards the rehabilitation plan of treatment. In
our view, social and psychological services must contribute
to the improvement of the individual’s rehabilitation
condition and may not relate to a mental health diagnoses.
In the CY 2008 PFS final rule (72 FR 66298), we discussed
the use of CPT codes 96150 through 96155 for health and
behavior assessment and treatment, which represent
full-scale clinical treatment of mental, psychoneurotic,
personality disorders and biopsychosocial functioning. We
revised the previous definition of CORF social and
psychological services and instructed that these services
should be limited to those described by CPT code 96152. We
stated that provision of other therapeutic services was
outside of the scope of coverage for CORFs. Since these
CPT codes were not a part of the proposed regulation, we
will not revisit the use of these CPT codes in this final
regulation.
We are finalizing our proposal to create the CORF
specific G-code which will be G0409. The description of
this G-code will be G0409, Social work and psychological
services. This code will directly relate to and/or further
373