Wiki Behavioral Health Billing

[combilling]

Hi,

We are considering taking over billing for a behavioral health office. They are trying to determine what is better reimbursement rates group or individual? Specific codes are 99204, 99214, 99213, 90837, 90834, 90832, T2023, H0018H0018, 99211. Any help would be greatly appreciated!

Thank you
Micah

 

[ahefner]

Keep in mind that medical necessity drives any care reimbursed by insurance and should truly drive any health care at all. Based on that, it depends on each provider and what type of care they are offering each specific patient. Each type of provider has their own reimbursement schedules through each type of insurance and if you are basing it off this then it depends on what each provider prefers their schedule to be. My provider mostly does 90837 and this rate is higher than 90834 of course but also higher than 90847. However, my previous employer mostly saw families so had a 45 minute schedule and mostly billed 90847 preferring to see more patients in a day to make up for the difference in cost. A cost analysis would be fairly easy to perform but of course, the type of need in the geographic area and the patient load would be the driving force to determine the average medical necessity for the practice.