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Mental Health Services Fee Schedule1Effective July 1, 2017, through June 30, 2018,
Prior authorization is required for all mental health services.
Procedure CodeDescription2NonFacility
Fee Schedule
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How to fill out mental health services fee
How to fill out mental health services fee
01
To fill out a mental health services fee, follow these steps:
02
Gather all necessary information, such as your personal details, insurance information, and any relevant medical history.
03
Contact your mental health service provider to inquire about their specific fee structure and payment policies.
04
Obtain the fee form or document from your mental health service provider.
05
Fill in your personal details accurately, including your full name, contact information, and date of birth.
06
Provide your insurance information, including the name of your insurance provider, policy number, and any relevant contact information.
07
If applicable, provide details about your mental health history, previous treatments, and any other relevant information that may assist in determining the fee.
08
Double-check all the information you have provided to ensure accuracy and completeness.
09
Sign and date the mental health services fee form.
10
Submit the completed form and any required supporting documents to your mental health service provider, following their instructions.
11
Keep a copy of the filled-out form for your records.
Who needs mental health services fee?
01
Mental health services fee is needed by individuals seeking professional mental health services. This may include individuals with diagnosed mental health conditions, those experiencing temporary emotional difficulties, individuals seeking therapy or counseling services, and anyone in need of mental health support and treatment. It is important to consult with a mental health professional or service provider to determine if a fee is applicable and to understand the specific requirements and conditions. Each case may vary depending on factors such as insurance coverage, the nature of the services required, and the policies of the mental health service provider.
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What is mental health services fee?
The mental health services fee is a fee charged for specific mental health services provided by healthcare professionals.
Who is required to file mental health services fee?
Healthcare professionals who provide mental health services are required to file the mental health services fee.
How to fill out mental health services fee?
To fill out the mental health services fee, healthcare professionals need to provide information on the mental health services provided and the corresponding fees.
What is the purpose of mental health services fee?
The purpose of the mental health services fee is to contribute to the funding of mental health services and programs.
What information must be reported on mental health services fee?
Healthcare professionals must report details of the mental health services provided and the fees charged for each service.
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