Mastering Mental Health Billing: A Detailed Guide

So we, of course, had to negotiate contracts for these services with each of our payers. And that was a little touchy at times, but overall it was a fine experience. And for those of you who are not very familiar with behavioral health insurance issues, a lot of patients‘ behavioral health coverage is actually carved out. So by virtue of this being a medical service, we have far more patients covered for the service than they would have been covered for behavioral health services in the same organization. But we still face issues with payers understanding and recognizing that this is medical and not behavioral health.

• But because we need to now mention that this will be a billed service, the patient’s natural reaction is „Well, how much?“ So we had to get creative with finding …
• Whether you work in an inpatient or outpatient setting, ICANotes can simplify your daily processes with our mental health billing solutions.
• The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product.
• If you have a deductible plan, you pay the full cost of services out of pocket until your deductible is met, at which time your insurance will start covering a percentage of your costs.
• Please note that the purpose of this webinar is informational only, and you should consult with a professional advisor for a specific medical, legal, financial, or other advice.
• If the claim has not been received, no corrected claim needs to be submitted, the original claim needs to be submitted.

It’s our goal to ensure you simply don’t have to spend unncessary time on your billing. We understand that it’s important to actually be able to speak to someone about your billing. Every provider we work with is assigned an admin as a point of contact.

Psychological/Neuropsychological Testing CPT Codes

We recommend reading and using Barbara Griswald’s book Navigating the Insurance Maze as a primer on how to submit paper claims correctly. Submit appointment dates with the requisite CPT codes and diagnosis codes. IF YOU MUST bill claims via paper, ask about their claims address as well.

Complete absence of all Bill Types indicates
that coverage is not influenced by Bill Type and the article should be assumed to
apply equally to all claims. Do not report the CPT add-on code for Interactive Complexity code in conjunction with Psychotherapy for crisis codes or in conjunction with E/M services when no psychotherapy service is also reported. Individual psychotherapy CPT codes should be used only when the focus of treatment involves individual psychotherapy.

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And one thing to remember is we only went over a few codes here that were eligible for telemedicine. It’s important to note when we did a webinar back in May, I think we had about 70 codes that were in the CPT, CPT codes that were designated as telemedicine eligible specifically. Go back to your EHR, online portal, or paper claims and refile these claims.

Our Definitive Guide to Mental Health CPT Codes

One or more of these problems — and many other variables — can make it difficult for mental and behavioral health providers to operate their practice efficiently. A lot of time and energy goes into filing a claim with medical billing for mental health services, taking away time from patients. Learning more about the mental health billing process can make it easier for you to spend more time and energy on your patients and less on inconvenient discrepancies.

Many of these are reported over extended periods, so many of our previous codes will be reported for a particular visit or an episode of service. These, you can tell you have a true ongoing relationship and a broader care management with the patient. In the case of cognitive assessment and care plan services, that’s reported once every 180 days. The General Behavioral Health Integration Care Management is really where you’re working with these patients and working with clinical staff, and it’s important… I thought that this was interesting, is that when I looked back at how this particular code was developed, actually the literature with all the CPT Category 1 codes… There are literature requirements that the CPT editorial panel makes these codes go through as part of a broader process for getting approval for a code.

The past and present status of that client’s insurance policy through a particular insurance company’s coverage. Research has shown that this brings about positive outcomes for young people, adults, and communities alike. The outdoors and stewardship education can provide a perfect setting for this important learning to take place. Try and get as much background information as possible about your participants before the outing, including any accommodations that may be needed. Use this to try and create as inclusive and safe of a space as possible for your group and to choose outdoor activity(s) that your whole group can take part in. The Avarna Group’s Inclusion Tips for Outdoor Program Staff can be a great starting point.

Downcoding (including less services on the claim than actually provided) will usually mean you get paid less, while upcoding (including more services on the claim than actually provided) can get you in trouble with your managed care panels. Read mental health billing our definitive guide with 2023 reimbursement rates for mental health CPT codes. Add-on codes are extremely important to use in order to most accurately describe the services being rendered and to ensure your services are maximized per session.

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This is a headache you don’t deserve nor are your trained to handle. In essence, while mental health billing and behavioral health billing share similarities, the latter encompasses a broader array of psychological services. Understanding their relationship is vital for practitioners, insurers, and policymakers working to improve access to comprehensive mental and emotional well-being care. In the healthcare domain, mental health billing takes center stage as a vital link between compassionate service and accurate financial processes. Let’s embark on a transformative journey through the detailed world of skillfully managing mental health billing services. Learn how to offload your mental health insurance billing to professionals, so you can do what you do best.

In this case, the cognitive assessment and care plan services is actually one of those codes. So I wanted to highlight that certainly, and I understand, based on yesterday, that I think the PHE has been extended another 90 days. Fighting denials and rejections is the hardest part of billing. This is yet one more reason why mental health providers choose billing services like TheraThink to help.

CPT is provided „as is“ without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is with CMS and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product.