Following is information for behavioral health providers on filing claims.
Does Blue Cross and Blue Shield of New Mexico allow supervisory billing?
Yes, supervisory billing is allowed with a formal relationship.
Must a trainee’s supervisor be the state supervisor, or would a clinic director or supervisor suffice?
The clinic supervisor or director can be the rendering provider if the supervisee is under a trainee license. In addition:
- There must be a direct supervisor-supervisee relationship.
- The supervisor must comply with regulations for the state in which the services are being rendered.
Should a modifier be used on outpatient claims?
No modifier is needed on claims.
Trainee supervision requires that supervisors be in the immediate vicinity of services 100% of the time. What does “immediate vicinity” mean?
Immediate vicinity means the Qualified Healthcare Provider, as supervisor:
- Is reachable to intervene to join a session in the same way it is being delivered
- Has reasonable accessibility to the supervisee to address concerns
- Must be compliant with state and/or federal regulations associated with the QHP’s respective licensure related to supervision