Attention ACTT Providers:
Partners is required, per Joint Communication Bulletin #J204, to make sure we capture the encounter data for Assertive Community Treatment Team (ACTT) services.
Partners has allowed providers to bill one unit per week (up to four), with the understanding that the provider is required by Clinical Coverage Policy to have a minimum of three contacts per week. The four contacts per month have been and continue to be required as face to face contacts.
Effective with November 1, 2016 dates of service, Partners is requiring all ACTT providers to submit their encounter claims. Providers are required to bill the following for clients receiving ACTT Services:
- For the four face to face contacts in the month, bill H0040 (These are the ones you receive the payment for and require an authorization)
- No authorization is required for the additional encounter claims. These additional contacts can include ones that are not face to face.
- For every client encounter, except the four face to face contacts, you will submit H0040 EN (so we capture every client interaction that is required in the Clinical Coverage Policy), with a minimum of three per week. These encounter claims should be billed at $0.01. This action will not generate a paid claim, but will allow the provider and Partners to capture the encounter.
This alert applies to both State Funded and Medicaid Funded ACTT consumers. Partners will ensure that these codes and modifiers are in your contract. If you have questions, please contact your Account Specialist.