mental health

  1. B

    Wiki Outpatient provider providing services to patient in the hospital

    Hi all, I have not come across this before so was hoping to get some guidance. I work for a behavioral health group practice in an outpatient setting (mainly office and telehealth). One of our LCSW's patients was admitted to the hospital due to an unrelated condition, and requested a session...
  2. A

    Wiki Testing codes psychiatry/psychology

    Can psychiatry bill testing codes, 96116, 96138/96139? or only by psychology?
  3. S


    Hopefully someone can help me with billing group session participation. I have a provider that wants to host group sessions for several different families together. As an example, it would be 3 or 4 couples processing a topic that is on all of their treatment plans. Since it is a group session...
  4. T

    Wiki XP and XE Modifiers - bill on each encounter? - Mental health

    Hi, I am unclear if we should be using XE and XP ( on each code for each encounter that qualifies. ) For example: Patient comes in and has all these services same day, one service by a different provider: T1017 1 unit 15 min - Case Manager A 90834 therapy session - Therapist B T1017 3 units...
  5. M

    Wiki Place of Service questions

    Hello! I am a somewhat new biller and got my experience solely from the office I currently work at and through AAPC billing course. I work for an Outpatient Drug and Alcohol treatment center, we also provide co-curring mental health/substance use services. The POS, Place of Service is always a...
  6. J

    Wiki UDS help

    We are switching to a new software soon and we normally have our MA's put the UDS and results in a note and sign it then the provider also signs it. Do we have to do this? Or can we just have them put it in as a non billable then when the provider interprets it, he change it to the 80307 and...
  7. S

    Wiki Provider moving practice location

    Hello everyone! We have a provider who left her previous practice, and is joining ours. We bill everything with our group NPI and tax ID, but individual NPI as rendering. We are in mental health, and she is our first prescriber (DNP). Everyone else at the practice is LPC, MSW, or LP. She is...
  8. E

    Wiki Ketamine Therapy and Observation

    Hi, Does anybody know the way to get reimbursed for the mandatory observation after administration of Sprevata or Ketamine infusion for depression or PTSD? I have the website from the manufacturer but that shows to use an E/M Code with a prolonged services code along with the injection (which...
  9. R

    Wiki Adolescent Residential billing for MH and SUD

    I need help. I have been billing for adults my whole career, but now have some questions regrading adolescents. This would be for residential care at a residential facility. Primary dx will usually be MH, and I cannot find any specific information on if billing will even change from what I am...
  10. D


    Hello, I work for Early intervention and Neurodevelopment center. We are the only agency that bill for Mental health therapy for birth to three in our county (and as of today I cannot find another agency that provides this service in our state). Our client base has high levels of Foster children...
  11. E

    Wiki 90971/90972 vs 9920x

    I am new to behavioral health, and I want to know when the appropriate times are to use these codes. I work on a college campus, so our providers are sometimes the first psychologists and psychiatrists to treat a client (and do the diagnosing). In that instance, the providers (psychiatrists) are...
  12. alvesey

    Wiki Audit Risk When 1 Dx Code is Listed on Claim When Multiple Exist in Notes?

    My employer is having software issues and a (hopefully temporary) fix has been proposed to include only 1 Dx code per claim. Are we increasing the risk of getting audited? We are a community mental health facility and serve a high Medicare/Medicaid population. Thank you for any assistance...
  13. A

    Wiki MH Service plans - H0032

    Can a mental health service plan (H0032) be billed for without being face-to-face with the client?
  14. J

    Wiki Behavioral health coding- help!

    Hello coding world, I am a brand new coder and took a position as the only coder/biller at a small counselors office. So, I don't have anyone above me to help with my questions. The question is regarding Arizona Medicaid and the correct code for services. The HCPCS code for a drug and/or...
  15. A

    Wiki T1023 - mental health screening

    Does anyone know what the requirements are for this code? Does it have to be face-to-face/ in-person or over the phone? I've been asked if this code can be used when a provider reviews documentation from a referral for a potential client. Thanks in advance.
  16. V

    Wiki Psychologist in SNF

    Fl Medicare billing... if the patient is in skilled care will a psychologist be paid by Medicare for the mental health visit? I see physicians will but my understanding is they are not considered physicians and will not be paid if the patient is in skilled care. Any experience with this?
  17. A

    Wiki Encountering multiple services for open Medicaid client

    I work for a Medicaid managed care organization and am wondering about the appropriateness around encountering/billing multiple services for a client when the client is open to services in multiple facilities. For example, if a client is in a psychiatric residential treatment facility, can a...
  18. T

    Wiki Need advice on dealing with Mental Health providers

    Hi I really need some advice on what I should do in this situation. I code for all the mental health providers in my practice. There is one in particular who seems to end up having cases where the patient was abused in the past. Unfortunately one of these patients is a still a child. When I...
  19. A

    Wiki Billing for services before MH assessment?

    I work for a Medicaid organization and am wondering if it is appropriate to bill for services before an assessment is done. For example... 1. Case Manager works on paperwork for a member for 30 minutes for housing prior to taking them face to face to Housing Authority for 1 hour- Can they bill...
  20. A

    Wiki MH & SUD Assessment, how often can these be billed?

    Can mental health and substance use disorder assessments be billed more often than once per year? Let's say there was an assessment done 10 months ago by a provider but they feel that another assessment is appropriate now due to the potential change in the patient's diagnosis and health status...
  21. A

    Wiki Medicaid Child & Adolescent Medication Management

    I cant find this in the Medicaid Manual or anywhere. My child psych doctors were told that whenever they do med mgt in day treatment program, they have to bill low whenever the parent is not around. I'm so confused on it. Does anyone have any input?
  22. S

    Wiki Advice on best book to have on hand for Behavioral Health coding & Billing

    Just started Billing & Coding for a Behavioral Health Center and wanted to see if anyone had suggestions on the best book & or tools to have on hand. I looked through AAPC, but wanted any and all opinions. Thank you for any and all help!!!
  23. A

    Wiki Psychotherapy billing to NYS Workers Compensation

    Help! For the first time I am billing a psychotherapy client to workers compensation. We used the 90834, however, the comp carrier is denying stating the code is invalid for the date of service. I can find nothing in the comp fee schedule and the carrier can provide us with no further...
  24. A

    Wiki Psychotherapy billing after auto accident

    Hi all, just gathering some input because this is not a situation I've come across yet. We had a patient who came for mental health counseling/individual psychotherapy for anxiety related issues within several days of an MVA where their vehicle was hit by another who was found at fault at the...
  25. K

    Wiki Residential Treatment and DCS Contracts

    I work for a mental health facility that has a contract with DCS as a residential treatment facility. We have a building for Level 2 and Level 3 patients. If they are in the state's custody, Level 3 clients' services are only billed to DCS. If they have private insurance, Level 3 client's...
  26. A

    Wiki Coding and Billing for Mental Health

    I am working with a Mental and behavioral health agency that has started to expand into the private insurance world. This is my first time working in mental health and i'm not overly familiar with the coding. Up till recently their primary insurance they were billing was our state medicaid...
  27. T

    Wiki Coding Behavioral Health Forms

    I am requesting opinions regarding what information from specific areas should be coded from Behavioral Health visit forms. Informational areas on the form are: Mental status, Medical symptoms (medical condition, medication, physical symptoms), Behavioral history, Substance use, eating habits...
  28. D

    Wiki Need help!!!!

    Hi all; I posted this last week and didn't get any response. I have a question regarding Medicare patients. Is there a regulation regarding the number of mental health visits a Medicare beneficary can have per year? Does it depend on if it is a parity dx or not? Any help would be appreciated...
  29. D

    Wiki Mental Health Visits for Medicare pts.

    Hi all; I have a question regarding Medicare patients. Is there a regulation regarding the number of mental health visits a Medicare beneficary can have per year? Does it depend on if it is a parity dx or not? Any help would be appreciated. Thanks again!