The Revenue Stream Can Now Flow: Billing Codes approved for Coordinated Specialty Care for FEP

David Shern, Brenda Jackson, Ken Farbstein

Abstract

Coordinated Specialty Care programs for Early Psychosis (CSC-EP) have struggled financially, despite the strong evidence base for their effectiveness. They’ve had to piece together funding for their teams from philanthropic donations, some fee-for-service reimbursement, temporary grants, the Community Mental Health Services Block Grant, and sometimes state contracts. Now the Centers for Medicare and Medicaid (CMS) has approved two team-based HCPCS [Medicaid] billing codes, which just became effective October 1, 2023. This poster will depict the next steps of the full adoption of the billing codes until provider teams can get routinely reimbursed for their CSC-EP. The poster will also portray the pathway that led to CMS approval.