Billing Guidance for Dialectical Behavioral Therapy (DBT)
Date: 08/13/25
DBT is a comprehensive, multi-diagnostic, modularized behavioral intervention designed to treat both adults and children/adolescents with severe mental disorders and uncontrolled cognitive, emotional and behavior patterns, including suicidal and/or self-harming behaviors.In alignment with Louisiana Department of Health requirements, Louisiana Healthcare Connections reimburses DBT services according to the guidance below.
Components
Individual therapy with a DBT-trained therapist: Typically provided for one hour per week, face-to-face (including telehealth) with an LMHP clinician and client;
Telephonic, therapeutic consultation/support/coaching (24-hour availability): A DBT program professional, usually the individual therapist, is available by telephone to each client at all times during the week, to extend problem-solving and coach skills to be used in real-world situations;
DBT skills training group: Typically 120–150-minute session held weekly in a group format, with all clients participating. Group is led by two co-leaders. For the treatment of adolescents, it is highly recommended that the skills training group be a multifamily skills training group, to include as active participants both the adolescent and a caregiver; and
Peer consultation team meetings: Each DBT team member (individual therapist, skills group co-leaders) participates in a weekly, one-hour consultation team meeting with other DBT practitioners in the same program.
Procedure Code(s)
| H2021 | H2021, Modifier HQ |
|---|---|
| Dialectical Behavioral Therapy, Individual | Dialectical Behavioral Therapy, Group |
Reimbursement Rates
| DBT Individual Therapy | DBT Group Psychotherapy |
|---|---|
| $200.00 per 60-minute session of DBT individual therapy per client per week | $177.68 per client for an expected 120-150-minute DBT skills-training group session per client per week. |
Please refer to the Louisiana Medicaid Specialized Behavioral Health Fee Schedule if you have questions or concerns regarding the reimbursement rates for DBT.
Modifiers
Below are the Age, Service Type, and Specialty modifiers allowed for DBT services:
| Age Modifiers | Service Type Modifiers | Specialty Modifier |
|---|---|---|
| Modifier HA –Child/Adolescent ProgramModifier HB –Adult Program | Modifier HQ –Group SettingModifier 95 –Telemedicine | Modifier AF –PsychiatristModifier SA –APRN/CNS/PA Modifier HP –Medical Psychologist Modifier AH –Psychologist Modifier AJ –LCSW Modifier HO –LPC/LMFT Modifier HF –LAC Modifier U4 –LMSW Modifier UA –PLPC/PLMFT |
Eligible Providers
DBT services must be rendered by the following provider types, and must have documented training in DBT and deliver services within their scope of practice.
Licensed Mental Health Professionals (LMHPs)
• Licensed Clinical Social Workers (LCSWs)
• Licensed Professional Counselors (LPCs)
• Licensed Marriage and Family Therapists (LMFTs)
• Licensed Psychologists
• Licensed Advanced Practice Registered Nurses (APRNs) with psychiatric certification
A DBT practitioner may receive reimbursement for the DBT service, when delivering DBT as part of a DBT team that is:
1. Trained and qualified to deliver DBT as described in the “Training” section, demonstrated by either:a. Certification from the DBT-Linehan Board of Certification (DBT-LBC);b. OBH-approved DBT qualification; orc. Engaged consistently and in good standing (as documented in writing by the OBH-sponsored training organization) in an OBH-sponsored DBT training program that will lead to an OBH-approved DBT qualification, following the agency and practitioner’s completion of the initial didactic training sessions, while under consultation with an OBH-approved DBT trainer.
Prior Authorization Requirements
The prior authorization requirements for DBT services are conditional:
- Authorization is not required if billed by a behavioral health specialty outpatient clinic.
- Authorization is always required if billed by a non-participating provider (not contracted in the Louisiana Healthcare Connections network).
Please refer to the Louisiana Healthcare Connections online Pre-Auth Check Tool if you have questions or concerns regarding the prior authorization requirements.