Many BHRS providers formerly categorized as Provider Type 50 have had numerous questions about the new provider types and specialty codes that have been assigned to them. PCPA has obtained the following information that may be helpful to these providers as they try to understand the changes occurring because of PROMISe.
If a provider’s BHRS services are based on their Outpatient Psychiatric Clinic, the provider would receive provider type 08, Clinic, with specialty codes of 548 (Therapeutic Staff Support Services - TSS), 549 (Mobile Therapy - MT) and/or 559 (Behavior Specialist Consultant - BSC).
If a provider’s BHRS services are based on their partial hospitalization or family based license, the provider would receive provider type 11, Mental Health/Substance Abuse, with specialty codes of 548 (TSS), 549 (MT) and/or 559 (BSC).
Other provider types (PT) and specialty codes (PS) for the conversion of Provider Type 50 are listed below:
|
PT 17 Therapist |
PS 174 Art Therapist |
|
PT 17 Therapist |
PS 175 Music Therapist |
|
PT 19 Psychologist |
PS 190 General Psychologist |
|
PT 21 Case Manager |
PS 212 MA Case Management |
|
PT 34 Program Exception |
PS 340 Program Exception |
|
PT 52 CRR |
PS 520 CRR Group Home |
|
PT 52 CRR |
PS 523 CRR Host Home |
|
PT 56 Residential Treatment Facility |
PS 560 RTF (Non-JCAHO Certified) |
|
PT 40 Medically Fragile Foster Care |
PS 400 Medically Fragile Foster Care |
Program exceptions are non-fee scheduled services. Providers must have an approved service description and get authorization from the Department of Public Welfare to bill for these services. These providers should submit their billings with the program exception number assigned.
Providers with questions should contact the appropriate numbers below.
OMHSAS Assistance Line
800-433-4459OMAP Provider Inquiry Line
Practitioner Unit 800-537-8862PROMISe email
promise@state.pa.us (Be sure to include the MAMIS provider number and a mailing address if requesting a PROMISe provider number that has not yet been received.)