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Issue Number - Name
0089 - Clinical Social Worker during Inpatient
Review Type
Automated
Claim Type
Clinical Social Worker
Region and State
RAC 1-4
All States
Date Approved
2018-02-13

Description

Services of Clinical Social Workers (CSW) rendered during inpatient hospital stay are included in the facility’s PPS payment and are not separately payable under Part B. CSW providers are expected to seek reimbursement from the facility.

Affected Code(s)

  • Psychiatry HCPCS/CPT Codes 90801-90899

Applicable Policy References

  • Title XVIII of the Social Security Act, Section 1833
  • CMS Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, Section 170
  • CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 3, Section 10.4