The “Cenpatico Fee Schedule” was created using the AHCCCS fee schedules that were in effect on October 1, 2015.
Cenpatico compensates each Provider pursuant to the terms set forth in Exhibit B – Compensation Schedule to the Providers’ RBHA Health Plan Product Attachment. Generally, a Provider is paid the lesser of (i) the Provider’s Billed Charges or (ii) the percentage of the Cenpatico Fee Schedule specified in Exhibit B. A 30% premium will be added to the reimbursement for Telemedicine Services reported with a GT modifier. In some instances, Cenpatico and Provider have negotiated exceptions for specific service codes, which are also provided in Exhibit B. Rate reimbursement is subject to change based on legislative and regulatory mandates. Cenpatico reserves the right to establish the implementation date of rate changes.
For additional information relating to the procedure codes, please see the ADHS/DBHS Allowable Procedure Code Matrix, Appendix B-2 to the ADHS/DBHS Covered Behavioral Health Services Guide.