Medication assisted treatment services - OTP counseling
Individual psychotherapy, 60 minutes (53+ minutes).
Per counseling session
- Medication assisted treatment services - OTP counseling. Counseling component of OTP.
MAT Services
Primary code
Aetna: $177.13
Optum: $0.00
Documentation & MDM Details
- Therapy duration: 53+ minutes documented
- Moderate to high complexity: crisis intervention, trauma processing
- Significant therapeutic content documented
- Patient in acute distress or working through complex trauma
- Detailed progress note with clinical formulation
MDM Checkpoints:
Complex presentation · Multiple data sources · Higher risk management
Frequency Note:
Medication assisted treatment services - OTP counseling. Counseling component of OTP.
Medication assisted treatment services - OTP drug screening
Individual psychotherapy, 60 minutes (53+ minutes).
Per drug screening
- Medication assisted treatment services - OTP drug screening. Required drug screening for OTP.
MAT Services
Primary code
Aetna: $108.85
Optum: $0.00
Documentation & MDM Details
- Therapy duration: 53+ minutes documented
- Moderate to high complexity: crisis intervention, trauma processing
- Significant therapeutic content documented
- Patient in acute distress or working through complex trauma
- Detailed progress note with clinical formulation
MDM Checkpoints:
Complex presentation · Multiple data sources · Higher risk management
Frequency Note:
Medication assisted treatment services - OTP drug screening. Required drug screening for OTP.
Medication assisted treatment services - OTP take-home
Individual psychotherapy, 60 minutes (53+ minutes).
Per take-home dose
- Medication assisted treatment services - OTP take-home. Take-home doses management.
MAT Services
Primary code
Aetna: $35.28
Optum: $0.00
Documentation & MDM Details
- Therapy duration: 53+ minutes documented
- Moderate to high complexity: crisis intervention, trauma processing
- Significant therapeutic content documented
- Patient in acute distress or working through complex trauma
- Detailed progress note with clinical formulation
MDM Checkpoints:
Complex presentation · Multiple data sources · Higher risk management
Frequency Note:
Medication assisted treatment services - OTP take-home. Take-home doses management.
Medication assisted treatment services - OTP stabilization
Individual psychotherapy, 60 minutes (53+ minutes).
Per stabilization
- Medication assisted treatment services - OTP stabilization. Stabilization phase services.
MAT Services
Primary code
Aetna: $86.26
Optum: $0.00
Documentation & MDM Details
- Therapy duration: 53+ minutes documented
- Moderate to high complexity: crisis intervention, trauma processing
- Significant therapeutic content documented
- Patient in acute distress or working through complex trauma
- Detailed progress note with clinical formulation
MDM Checkpoints:
Complex presentation · Multiple data sources · Higher risk management
Frequency Note:
Medication assisted treatment services - OTP stabilization. Stabilization phase services.
Medication assisted treatment services - brief intervention
Individual psychotherapy, 60 minutes (53+ minutes).
Per brief intervention
- Medication assisted treatment services - brief intervention. Brief MAT intervention.
MAT Services
Primary code
Aetna: $30.54
Optum: $0.00
Documentation & MDM Details
- Therapy duration: 53+ minutes documented
- Moderate to high complexity: crisis intervention, trauma processing
- Significant therapeutic content documented
- Patient in acute distress or working through complex trauma
- Detailed progress note with clinical formulation
MDM Checkpoints:
Complex presentation · Multiple data sources · Higher risk management
Frequency Note:
Medication assisted treatment services - brief intervention. Brief MAT intervention.
Collaborative care management - first month
Individual psychotherapy, 60 minutes (53+ minutes).
Once per patient (first month)
- Collaborative care management - first month. Initial month of collaborative care program.
Care Management
Primary code
Aetna: $720.97
Optum: $0.00
Documentation & MDM Details
- Therapy duration: 53+ minutes documented
- Moderate to high complexity: crisis intervention, trauma processing
- Significant therapeutic content documented
- Patient in acute distress or working through complex trauma
- Detailed progress note with clinical formulation
MDM Checkpoints:
Complex presentation · Multiple data sources · Higher risk management
Frequency Note:
Collaborative care management - first month. Initial month of collaborative care program.
Collaborative care management - subsequent months
Individual psychotherapy, 60 minutes (53+ minutes).
Monthly (subsequent)
- Collaborative care management - subsequent months. Ongoing collaborative care after first month.
Care Management
Primary code
Aetna: $1,052.82
Optum: $0.00
Documentation & MDM Details
- Therapy duration: 53+ minutes documented
- Moderate to high complexity: crisis intervention, trauma processing
- Significant therapeutic content documented
- Patient in acute distress or working through complex trauma
- Detailed progress note with clinical formulation
MDM Checkpoints:
Complex presentation · Multiple data sources · Higher risk management
Frequency Note:
Collaborative care management - subsequent months. Ongoing collaborative care after first month.
Collaborative care management - psychiatric consultation
Individual psychotherapy, 60 minutes (53+ minutes).
Per consultation
- Collaborative care management - psychiatric consultation. Psychiatric consultation for CoCM.
Care Management
Primary code
Aetna: $406.44
Optum: $0.00
Documentation & MDM Details
- Therapy duration: 53+ minutes documented
- Moderate to high complexity: crisis intervention, trauma processing
- Significant therapeutic content documented
- Patient in acute distress or working through complex trauma
- Detailed progress note with clinical formulation
MDM Checkpoints:
Complex presentation · Multiple data sources · Higher risk management
Frequency Note:
Collaborative care management - psychiatric consultation. Psychiatric consultation for CoCM.
Collaborative care management - care team support
Individual psychotherapy, 60 minutes (53+ minutes).
Per support session
- Collaborative care management - care team support. Care team support services.
Care Management
Primary code
Aetna: $363.64
Optum: $0.00
Documentation & MDM Details
- Therapy duration: 53+ minutes documented
- Moderate to high complexity: crisis intervention, trauma processing
- Significant therapeutic content documented
- Patient in acute distress or working through complex trauma
- Detailed progress note with clinical formulation
MDM Checkpoints:
Complex presentation · Multiple data sources · Higher risk management
Frequency Note:
Collaborative care management - care team support. Care team support services.
Collaborative care management - care coordination
Individual psychotherapy, 60 minutes (53+ minutes).
Per coordination session
- Collaborative care management - care coordination. Care coordination activities.
Care Management
Primary code
Aetna: $68.04
Optum: $0.00
Documentation & MDM Details
- Therapy duration: 53+ minutes documented
- Moderate to high complexity: crisis intervention, trauma processing
- Significant therapeutic content documented
- Patient in acute distress or working through complex trauma
- Detailed progress note with clinical formulation
MDM Checkpoints:
Complex presentation · Multiple data sources · Higher risk management
Frequency Note:
Collaborative care management - care coordination. Care coordination activities.
Methadone administration and/or service by licensed program
Individual psychotherapy, 60 minutes (53+ minutes).
Per administration
- Methadone administration by licensed program. Includes dispensing and observation.
MAT Services
Primary code
Aetna: $0.00
Optum: $248.75
Documentation & MDM Details
- Therapy duration: 53+ minutes documented
- Moderate to high complexity: crisis intervention, trauma processing
- Significant therapeutic content documented
- Patient in acute distress or working through complex trauma
- Detailed progress note with clinical formulation
MDM Checkpoints:
Complex presentation · Multiple data sources · Higher risk management
Frequency Note:
Methadone administration by licensed program. Includes dispensing and observation.
Oral medication administration, direct observation
Individual psychotherapy, 60 minutes (53+ minutes).
Per administration
- Oral medication administration, direct observation. For MAT programs requiring observed dosing.
MAT Services
Primary code
Aetna: $0.00
Optum: $289.98
Documentation & MDM Details
- Therapy duration: 53+ minutes documented
- Moderate to high complexity: crisis intervention, trauma processing
- Significant therapeutic content documented
- Patient in acute distress or working through complex trauma
- Detailed progress note with clinical formulation
MDM Checkpoints:
Complex presentation · Multiple data sources · Higher risk management
Frequency Note:
Oral medication administration, direct observation. For MAT programs requiring observed dosing.
Community psychiatric supportive treatment program, per diem
Individual psychotherapy, 60 minutes (53+ minutes).
Per diem
- Community psychiatric supportive treatment program. Daily rate for intensive services.
MAT Services
Primary code
Aetna: $0.00
Optum: $57.10
Documentation & MDM Details
- Therapy duration: 53+ minutes documented
- Moderate to high complexity: crisis intervention, trauma processing
- Significant therapeutic content documented
- Patient in acute distress or working through complex trauma
- Detailed progress note with clinical formulation
MDM Checkpoints:
Complex presentation · Multiple data sources · Higher risk management
Frequency Note:
Community psychiatric supportive treatment program. Daily rate for intensive services.
Alcohol and/or other drug abuse services, not otherwise specified
Individual psychotherapy, 60 minutes (53+ minutes).
Per service episode
- Alcohol and/or other drug abuse services. Comprehensive substance use treatment.
MAT Services
Primary code
Aetna: $0.00
Optum: $1,557.02
Documentation & MDM Details
- Therapy duration: 53+ minutes documented
- Moderate to high complexity: crisis intervention, trauma processing
- Significant therapeutic content documented
- Patient in acute distress or working through complex trauma
- Detailed progress note with clinical formulation
MDM Checkpoints:
Complex presentation · Multiple data sources · Higher risk management
Frequency Note:
Alcohol and/or other drug abuse services. Comprehensive substance use treatment.
Coordinated specialty care - per diem
Individual psychotherapy, 60 minutes (53+ minutes).
Per diem
- Coordinated specialty care - per diem. Daily rate for coordinated specialty care programs.
Care Management
Primary code
Aetna: $0.00
Optum: $24.22
Documentation & MDM Details
- Therapy duration: 53+ minutes documented
- Moderate to high complexity: crisis intervention, trauma processing
- Significant therapeutic content documented
- Patient in acute distress or working through complex trauma
- Detailed progress note with clinical formulation
MDM Checkpoints:
Complex presentation · Multiple data sources · Higher risk management
Frequency Note:
Coordinated specialty care - per diem. Daily rate for coordinated specialty care programs.