Billing support data also provides the information necessary to bill for all children’s Health Home rate codes, including the program’s standard codes (1864 – 1866), outreach code (1863), and CANS assessment rate code (1868).
The children’s billing support questionnaire includes programmatic questions regarding core services, ACT services, and foster care. When completing Billing Support, CMA users must ensure that answers to these questions account for the policy guidelines surrounding each related program and rate code.
In contrast to the adult billing support questionnaire, the children’s billing support questionnaire includes only a single clinical question about the child’s diagnoses. Instead of using the clinical information provided here to determine the appropriate rate code for the patient that month, the children’s billing support questionnaire looks to the acuity score that was assigned to the patient at the conclusion of their most recent CANS assessment.
For that reason, Foothold Care Management encourages children’s Health Home providers to complete the CANS assessment before completing the billing support questionnaire for the patient that month. If a billing support questionnaire is submitted before the completion of the CANS assessment, MAPP will automatically assume a low acuity score and assign the patient the associated low rate code for the month in question. For more information on the children’s Health Home rate codes see the documentation provided below: