N.Y. Comp. Codes R. & Regs. tit. 12 § 333.2

Current through Register Vol. 46, No. 25, June 18, 2024

Section 333.2 - Behavioral Health fee schedule; incorporation by reference

(a) The behavioral health fee schedule for psychology services shall be the Official New York Workers' Compensation Behavioral Health Fee Schedule, updated December 11, 2019 , prepared by the Board and published by OptumInsight, which is herein incorporated by reference.

(b) The Official New York Workers' Compensation Behavioral Health Fee Schedule incorporated by reference herein may be examined at the office of the Department of State, One Commerce Plaza, 99 Washington Avenue, Albany, NY 12231, the Legislative Library, the libraries of the New York State Supreme Court, and the district offices of the board. Copies may be purchased from OptumInsight, by writing to Official New York Workers' Compensation Fee Schedule, PO Box 88 050, Chicago, IL 60680-9920; by telephone at 1-800-464-3641, option 1; or online at www.optum36-coding.com keyword New York or https://www.optum360coding.com/Product/40508/.

(c) Authorized providers, including psychologists and licensed clinical social workers, shall use the following Common Procedural Technology (CPT) codes when telemedicine is used in accordance with section 325- 1.8 of this Title, notwithstanding these codes not appearing in the Official New York Workers' Compensation Behavioral Health Fee Schedule. Use of these codes are limited to one unit per patient per day. Use of these codes are not eligible for the enhanced reimbursement in Modifier 1B of Ground Rule 9.

(1) 99441 (telephone evaluation and management services provided to an established patient; 5-10 minutes of medical discussion);

(2) 99442 (telephone evaluation and management services provided to an established patient; 11-20 minutes of medical discussion); and

(3) 99443 (telephone evaluation and management services provided to an established patient; 21-30 minutes of medical discussion).

N.Y. Comp. Codes R. & Regs. Tit. 12 § 333.2

Amended New York State Register December 26, 2018/Volume XL, Issue 52, eff. 4/1/2019

Amended New York State Register December 11, 2019/Volume XLI, Issue 50, eff. 1/1/2020

Amended New York State Register April 1, 2020/Volume XLII, Issue 13, eff. 3/16/2020

Amended New York State Register April 26, 2023/Volume XLV, Issue 17, eff. 4/11/2023