clinical social work association

[The Aware Advocate is an occasional newsletter sent to members with information that is relevant to Licensed Clinical Social Workers ~LWG]

This episode of The Aware Advocate will focus on POS Codes for Medicare; Public Health Emergency extension; and the Social Work Compact development.

POS Codes for Medicare

There remains a lot of confusion about which POS codes should be used for Medicare.  Here is a reminder of what Medicare and other insurers are requiring for claims:

• POS “11” should be used until the end of the Public Health Emergency, timing of which is currently the end of 2022, even though this POS “11” is for office visits.
• POS “10” was made “available” for LCSWs for telemental health treatment as of April 4; however, there is a rate cut for those who have used POS “10” so using POS “11” is a better option.
• POS “10” will be required for telemental health when the Public Health Emergency ends, currently the end of 2022.
• Check with YOUR Medicare Administrative Contractor to clarify which POS code is being accepted currently if the patient is being seen through telemental health in their home.
• You can find your MAC contact information at the CSWA website under “Clinical Practice”.
• If a patient is seen in their car, the POS code should be “02”, but POS “11” is also acceptable. 
• The Medicare Modifier for all POS codes is still 95. This may seem counterintuitive as 95 is supposed to be for telemental health, but it is the only combination that currently works.

Be sure to check with EACH private insurer for a patient to find out what combination of POS and Modifier are being requested so that claims will not be denied.

Public Health Emergency

The Public Health Emergency is predicted to be in effect until the end of 2022, possibly longer.  I will be keeping you informed on any changes that take place which may affect Medicare coverage and commercial insurance.

Social Work Compact

As you know, CSWA began working as part of the Technical Assistance Group (TAG) in October of 2021, along with representatives from ASWB, NASW, CSWE, and Department of Defense and the Council of State Governments to create a Social Work Compact.  The latter two groups listed are funding the effort to create a compact for clinical social workers that would allow us to work in any state that has joined the Compact.  The process for creating the Compact is as follows:

• States will join the Compact by passing legislation through the state legislatures after the draft legislation is approved by DoD and CSG
• The draft legislation will be open for public comment some time this summer. I will let you know how to access the draft and send in your comments when it is available
• The draft will likely go out to states in late 2022 or early 2023

Once the process is moving forward, we will need to have a legislative campaign to pass the Compact in as many states as possible.  I will be sending materials to help you make the case for the Compact in your state.

Let me know if you have any questions about any of these issues.

Laura Groshong, LICSW, Director, Policy and Practice