Correcting payment errors: an update on peer recovery support services

This communication serves as a critical alert concerning the VA MHS Manual, specifically related to the peer recovery support services supplement codes T1012, S9445, H0024 and H0025.

As per the established guidelines in the manual, these respective service codes have the following combined limits:

• T1012 and S9445 have a unit value of one unit per 15 minutes and combined daily limit of four hours or 16 units for each calendar day. This totals for a limit of 900 hours or 3600 units per calendar year.
• H0024 and H0025 have a unit value of one unit per 15 minutes and combined daily limit of four hours or 16 units for each calendar day. This totals for a limit of 900 hours or 3600 units per calendar year.

It has come to our attention that a discrepancy exists in the setting of the yearly limit for these codes. They were incorrectly configured to only allow 900 units per calendar year, reflecting the total hours rather than the expected total units.

Efforts are underway as part of an expedited request to remedy this configuration error.

September 30, 2024, is the estimated completion date for this work. Upon the completion of this correction, any claims affected by this issue will be reprocessed within 60 days.

This scenario is regrettable, and we apologize for the inconvenience to our affected care providers.