Wiki Behavioral Health Phone only billing

[Peanut011]

I work for a non-profit behavioral health agency. We employ licensed therapist, QMHA's and QMHP's. Are there codes we can use to bill for phone only therapy for individual, family, or even group therapy? I cannot find the definition of a "other qualified health care professional" and most of the codes refer to "medical" discussions. Any help would be greatly appreciated.

 

[Kristen Bensel]

Generally I have found that "other qualified health care professionals" indicates that these individuals must be a billable provider type with the payers to provide the services. Remember your providers are making "medical decisions" about their patients conditions and care.
There are CPT's for nonphysican phone calls that I believe LCSW's and QMHP/A's would qualify for, (I don't have my book with me right now to give the exact numbers, but look in the medicine section around physical therapy and behavioral health services). However, these phone calls are not for routine visits. They are for acute conditions that the patient hasn't been seen for in the past 7 days and won't be in the clinic within the next 24 hours for. And they have to be an established patient to the clinician or agency in your case.
I work for a multi-specialty clinic that has behavioral health services, and we are currently trying to identify the best way to continue care for our patients without bringing them into the clinic.
We regularly use telemedicine for our pediatric psychiatrist, but the kids come to the clinic and she is off site.
Right now CMS has allowed for facetime and zoom to be utilized for telemedicine services with patients who still need services without having to come in. If you go down that route, the visits are billed the same as a in office therapy session, you would just need to check with your payers to see if they require the GT modifier or not and if they have any other restrictions to those kinds of services. These would also need to be for established patients.