I would start by finding out if your state has a LCD. You can find LCD information by going to http://www.cms.gov/medicare-coverage...ck-search.aspx . Here in CT, we have two LCDâ€™s: L26398 R2 Psychiatric Partial Hospitalization Programs and L26895 R6 Outpatient Psychiatry and Psychology Services. The LCD lists who can perform the service, who can bill for the services, and what documentation is needed to support the services billed, along with other helpful information. In CT, Medicare does cover services performed by a clinical social worker which are paid on the different fee schedule than the physicians. I would also look into using the AJ-modifier for professional billing. I hope this information helps you on your journey.
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