Billing / Billing Codes

On Dec. 1, 2020, the Centers for Medicare and Medicaid Services (CMS) released the final rule for the Medicare Physician Fee Schedule. The rule is effective Jan. 1, 2021, and applies to Medicare providers including clinical social workers.

NASW’s Task Force for Private Practice Guidelines is seeking public comments for the document, Clinical Social Workers in Private Practice: A Reference Manual. This manual provides a useful set of guidelines for clinical social workers starting a private practice and for seasoned clinical social workers seeking specific information related to the practice and business side of a private practice. Your comments are important to us and will determine how the task force moves forward. The public comment period begins December 4, 2020, and ends January 4, 2021.

With the emergence of the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) has temporarily expanded its telehealth policies on an emergency basis under the 1135 waiver authority and the Coronavirus Preparedness and Response Supplemental Appropriations Act.

The Centers for Medicare and Medicaid Services announced on April 3, 2020, revisions for telehealth place of service (POS) and modifier codes. The revisions will allow clinical social workers (CSWs) to be reimbursed at the samerate as an in-person service.

Beginning January 1, 2020, new Health Behavior Assessment and Intervention (HBAI) Current Procedural Terminology (CPT) Codes were implemented.

An increasing number of clinical social workers have reported to NASW that paper claims submitted on the CMS-1500 form are being denied because boxes 14 and 15 were not completed.