DMC State Billing Manual Changes

3.1.3 Monthly MEDS Extract File (MMEF) section.
- Contains, among other data, all Aid Codes for which beneficiaries who are the county’s responsibility are eligible at the date/time the file was created
4.1.7 Mobile Crisis Services
5.2.6 Beneficiary’s Gender must still be report but will not be verified by MEDS.
5.2.28 Other Health Care Coverage – Non-Medicare added Eligible Services Peer Support Services and Claims for services that were provided by an intern or resident and therefore carry an HL or GC modifier.
6.1 Federal Share: FMAP Percentage and Aid Codes
Adds - The federal share for services funded by the American Rescue Plan Act (ARPA) is 85 percent of the total approved. Mobile crisis services are currently the only ARPA-funded services.
New Procedure Codes
- H0025-Behavioral health prevention education services, 15 minutes
- H2011- Mobile Crisis In Service Table 10

5.2.20 Perinatal and Non-Parinatal Services

Service Code H2011 is moved to it’s own section in Mobile Crisis Codes
Taxonomy Codees
Marriage and Family Therapist (MFT) or Licensed Professional Clinical Counselor (LPCC) added 101Y
Licensed Clinical Social Worker (LCSW) removed 102X,103L,1714, 225C,222Q
New Definitions
- Direct Patient Care
- Intern
Modifier 59 – Removed Note “Modifier 59 should not be appended to an evaluation and management service.”
Modifier 95 – When to use added “If using this modifier, indicate that the service was provided in Place of Service 02 or 10.”
Modifier HV- added exception “Counties must include modifier HV when submitting MAT services claims. Methadone provided in NTP settings does not fall under this funding requirement.”
Modifier HW- Code applies to “H2011 with place of service 15 (mobile crisis)”
Modifier SC- If using this modifier, indicate that the service was provided in Place of Service 02 or 10 unless billing for mobile crisis.
Modifier SC- This modifier only applies to HCPCS codes.