REAL-LIFE SCENARIO:
A teacher referred the student after reading the student’s journal entry about suicidal ideation. The provider met with the student to conduct a risk assessment using the C-SSRS and provided crisis counseling. The student rated low risk. The provider and student discussed coping strategies for when the student feels overwhelmed, and the student returned to class. The provider called the student’s parent and held a meeting at school to review the results and create a home safety plan. In total, the provider documents 1.5 billable hours of service.
What the provider did | Service billed | Time | Details |
1. Crisis counseling with student | Psychotherapy – Crisis | 60 min | Individual crisis counseling session; completed C-SSRS screener. Student rated low risk. |
2. Phone call to parent/guardian | Case Management – Targeted | 10 min | Notified parent of the journal entry and the low-risk result. |
3. Parent meeting at school | Training – Family Training and Counseling | 20 min | Met with parents and student to review results and create a home safety plan. |
Total billable time | 90 min | 1.5 hours across 3 services, submitted on one claim |
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Why three services? Each part of the response is a different type of work, so each is billed under its own service type on a single claim.
HOW TO BILL THIS IN TADHEALTH
Follow these steps to document and bill the scenario above.
Step 1 | From the student profile, click on “New Care Event” |
Step 2 | Enter the Date, Start Time, and End Time In “Care Event Details,” the start and end times should reflect the total combined time spent providing services within the Care Event, even if there are gaps between activities (e.g., Start Time: 9:00 AM; End Time: 10:30 AM).
Document the time spent on each individual service in the respective service’s note (see step 7). This provides an accurate breakdown of time spent, beyond the selected billing duration ranges. |
Step 3 | Select Add Services, Add Psychotherapy – Crisis (60 minutes) Select Psychotherapy → Crisis, then choose 31–60 minutes from the time dropdown. Include the time spent on the C-SSRS screener. |
Step 4 | Add Case Management – Targeted (10 minutes) Select Case Management → Targeted, then choose 8–15 minutes for the call to the parent/guardian. This call happened after the student left, so it is billed separately. |
Step 5 | Add Training – Family training and counseling (20 minutes) Select Training → Family training and counseling, then choose 16–30 minutes for the parent meeting. |
Step 6 | Click Continue, review, and Confirm to finish adding services Confirm all three services and their times are correct (Crisis 1 hr, Case Management 10 mins, Family training 20 mins). Note: CYBHI displays the upper limit of each billable time range, so a 10-minute service may display as 15 minutes.
Under What did you focus on?, select “crisis support or intervention”, then click Confirm to add the services to the Care Event. |
Step 7 | Complete Documentation Write your notes in the Documentation section. Add an additional note for each individual billable service attached to the Care Event.
Sample note 1: Psychotherapy - Crisis (60 min) - Student's journal entry included thoughts of self-harm. Met with student for an individual crisis check-in. Assessed current safety, explored triggers and protective factors, and administered the C-SSRS. Results indicated low risk. Student denied current intent or plan and practiced coping strategies. Student returned to class.
Sample note 2: Case Management - Targeted (10 min) - Called parent to inform them of the journal entry, the outcome of the risk screening (low risk), and recommended next steps. Parents agreed to meet at school.
Sample note 3: Training - Family Training and Counseling (20 min) - Met with parent and student at school to review risk assessment results, identify warning signs, and develop a home safety plan including supervision and follow-up support. Parent verbalized understanding of the plan. |
Step 8 | Complete Screener Use the “Add Screener” feature to record the C-SSRS responses and determine risk level (low risk) so it is attached to the Care Event. |
Step 9 | Sign & Complete Type your full name to sign, then click “Sign & Complete” to submit the claim. |
QUICK TIPS & REMINDERS
✓ | Screener time (C-SSRS, district-specific form, etc.) is part of Psychotherapy – Crisis. No separate screener service is required for crisis services. |
✓ | You must continue following your district’s screening and documentation procedures. Using the C-SSRS screener in a Care Event is optional and allows you to attach results and track progress. |
✓ | Case Management is billed after the student has left the session, not during it. |
✓ | Calls made during the active crisis session count toward Psychotherapy – Crisis time, not Case Management. |
✓ | If a crisis counseling session exceeds 90 minutes, bill the remaining time as Psychotherapy – Therapeutic Session. |
✓ | Choose the duration of time that contains your actual minutes for each service. |
✓ | Low-risk results are still documented and billable. Record the screener result and the actions you took. |
✓ | All services from one event go on one claim. Review everything on the Quick review screen before confirming. |
✓ | Services provided on a different day (e.g., re-entry meeting or a family follow-up) must be documented as a separate care event. |
TadHealth | Risk & Threat Assessment Quick Guide