Dialectical Behavior Therapy (DBT) ARPA Incentives Effective March 1, 2024
Date: 03/28/24
Louisiana Healthcare Connections would like to inform providers that the Centers for Medicare and Medicaid Services (CMS) has approved Louisiana’s submission of a State Directed Payment request to utilize funding to offer increased psychotherapy reimbursement rates for Dialectical Behavior Therapy (DBT) individual therapy and DBT group psychotherapy, effective for dates of service on or after March 1, 2024. Louisiana Healthcare Connections will recycle any impacted claims. No action is needed by providers.
The incentive payments are summarized below by service and are in effect for the period March 1, 2024 through March 2025 or until funds are exhausted, whichever comes first.
| Psychiatrist Base Payment | Psychiatrist Add-on Payment | Incentivized DBT Toal | APRN & Psyhologist Base Paymen | APRN & Psyhologist Add-on Paymen | Incentivized DBT Total | Other LMHP Base Payment | Other LMHP Add-on Payment | Incentivized DBT Total | ||
| Code, Modifier | Description | Age | Modifier: AF | Modifier: AF | Modifier: AF | Modifier: AH, SA, or HP | Modifier: AH, SA, or HP | Modifier: AH, SA, or HP | Modifier: AJ, HO, or HF | Modifier: AJ, HO, or HF | Modifier: AJ, HO, or HF |
| H2021 | Individual DBT Session | 0-20 | $98.78 | $101.22 | $200.00 | $79.02 | $120.98 | $200.00 | $69.15 | $130.85 | $200.00 |
| H2021 | Individual DBT Session | 21+ | $76.74 | $123.26 | $200.00 | $61.39 | $138.61 | $200.00 | $53.72 | $146.28 | $200.00 |
| H2021, HQ | Individual DBT Session | 0+ | $176.40 | $1.28 | $177.68 | $141.12 | $36.56 | $177.68 | $123.52 | $54.16 | $177.68 |
The total rate is $200.00 per 60-minute DBT individual therapy, with an expected 60-minute session of DBT individual therapy per client per week. Providers will bill H2021 for DBT individual psychotherapy.
The total rate is $177.68 per client for DBT group psychotherapy for an expected 120–150-minute DBT skills-training group sessions per client weekly. Providers will bill H2021 with the HQ modifier for DBT group psychotherapy.
Louisiana Healthcare Connections will pay the eligible providers based on the submission of eligible claims and will ensure the accurate and timely processing of claims and encounters.
Providers who comply with all the following:
• Complete the initial week of DBT didactic training through LSUHSC,
• Remain in good standing with the training program,
• Be credentialed with Louisiana Healthcare Connections,
• Comply with all DBT service requirements in the Medicaid manual and
• Provide a DBT individual or group therapy session post-ompletion of the initial didactic training to receive the increased psychotherapy rates.
Thank you for your continued support and commitment to the care of our members. If you have questions about this communication, please contact Provider Services at 1-866-595-8133 or your Provider Network Representative.