Wiki Using the "SA" modifier to bill Licensed Mental Health Counselor Associates question....

[jackiestout]

Question to all coders....
I work in a clinic where we have Licensed mental health associates that work under Licensed mental health counselors and social workers. I have a biller that I just met, that uses the "SA" modifier when she bills for an associate under a credentialed and licensed mental health counselor. Everything that I read about that modifier, it goes more towards, either nurse practitioners, or psychiatric nurse practitioners. Does anyone else out there in the world use this modifier in this type of office setting?
Thank you for your feedback -

 

[ckeeney]

SA is definitely for NP/APN and usually only needed if they are billing under a supervising physician. We use HE per our state (Indiana) Medicaid guidelines. LCSW's are AJ.

For most non-Medicaid payers we bill under whoever rendered without any modifier and we do end up writing off some. I did see a number of modifiers starting with H that might be more appropriate such as HN Bachelor's degree level or HO for Master's level if billing under an allowable supervising clinician.

All this to say, check the payers (or at least the ones with the most volume).