Effective for dates of service on or after March 1, 2025, Certified Family Partner (CFP) services (procedure code S9482) will be a benefit of Texas Medicaid.
Overview of Services:
CFP services, also referred to as family partner support services or family peer support services, will be a benefit of Texas Medicaid for parents (birth, adoptive, and foster), legally authorized representatives (LARs), or primary caregivers of a Medicaid-eligible child or youth who meets the following criteria:
- Is 20 years of age or younger
- Is diagnosed with a serious emotional disturbance (SED) or a mental health or substance use condition, as defined in the current edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM)
- Has CFP services included as a component in their person-centered and trauma-informed recovery plan (henceforth referred to as the plan of care)
CFPs provide services directly to the parents, LARs, or primary caregivers, not to the Medicaid-eligible child or youth.
CFP services are an array of formal and informal services and support that include the following:
- Introducing parents, LARs, or primary caregivers to the mental health and substance use system
- Modeling advocacy skills
- Providing education and information
- Making referrals
- Providing skills training
- Assisting in identifying supports
- Conducting support groups
- Helping with navigating systems, such as the juvenile justice system, child protective services, and independent school districts
CFP services may be provided in the office, home, outpatient hospital, and “other location” settings. CFP services may also be provided by telehealth if certain conditions are met.
CFP services may be delivered as part of a coordinated, comprehensive, and individualized approach to treating a Medicaid-eligible child’s or youth’s SED or mental health or substance use condition. CFPs may not submit claims directly to Texas Medicaid for family partner support services. CFPs must be employed by one of the following Medicaid-enrolled provider types that may submit claims for the CFP services rendered:
- Clinic and group practices treating behavioral health conditions
- Physicians, advanced practice registered nurses, and physician assistants treating behavioral health conditions
- Licensed psychologists, licensed clinical social workers, licensed marriage and family therapists, and licensed professional counselors
- Comprehensive provider agencies of mental health targeted case management and mental health rehabilitative services
- Local mental health or behavioral health authorities (LMHAs or LBHAs)
- Chemical dependency treatment facilities
- Federally qualified health centers
- Rural health clinics
- Opioid treatment providers
Claim Submission Guidelines:
CFP services must be included in the plan of care for the Medicaid-eligible child or youth to be reimbursed.
A billable unit of CFP services (procedure code S9482) is 15 minutes of continuous contact.
The following modifiers may be submitted with procedure code S9482:
| Modifier | Use For |
| 95 | Delivered by synchronous audiovisual technology |
| FQ | Delivered by synchronous audio-only technology |
| HE | Mental health program |
| HF | Substance use program |
| HQ | Group-delivered services |
Claims for CFP services using procedure code S9482 must be submitted with modifier HE or HF, as appropriate. Claims for CFP services delivered in a group setting must also be submitted with modifier HQ. CFP services are limited to 104 units in a rolling six-month period. This limit may be exceeded with prior authorization.
Beginning March 1, 2025, additional CFP benefit information will be published in the Texas Medicaid Provider Procedures Manual, Behavioral Health and Case Management Services Handbook.
For more information, call the TMHP Contact Center at 800-925-9126.
Providers are encouraged to share this information with their staff. If you have any questions about this notice, please email Provider Relations at ProviderRelations@cfhp.com or call 210-358-6294. You can also contact your Provider Relations Representative directly.
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