CPT Codes 99214 and 99215: Choosing Between These Codes for Behavioral Assessment Billing

What is it, who can bill for it and who will reimburse it?

These two Current Procedural Terminology Codes belong to a certain “family” of billing codes that includes 99211-99215. They are also a part of the Healthcare Common Procedure Coding System. You can expect to see CPT Codes 99214 and 99215 used for office visits for medical and mental health conditions. These appointments must be for already established patients only.

CPT Codes 99214 and 99215 can be viewed as extremely similar. Therefore, it is understandable that some healthcare professionals might find differentiating between their billing choices rather confusing. These two codes may be connected in many different ways, but they do require some completely different components for billing. Therefore, paired with the fact that one code is reimbursable for a higher amount, it is important for clinicians to ensure that they are receiving the highest monetary amount possible for their reimbursements for billing. However, it is even of greater importance to ensure that these reimbursements are processed successfully.

Many clinicians find that they bill with CPT Code 99215 very frequently, but some worry that it will be more difficult for reimbursement. However, once you know the rules and regulations and stick to them, you will find that billing with either code is simple. Let’s take a look at both CPT Codes 99214 and 99215 to learn more.

 

What exactly are CPT Codes 99214 and 99215?

CPT Code 99214 is a code that is issued for the second highest level of care for a patient’s office visit. CPT Code 99214 can only be used for an established patient’s office visit, and it is a level four code. It can be used to bill for an in-office visit or in an outpatient setting. Reimbursement for 99214 is more than 99212 or 99213. This is exactly why CPT Code 99214 is used the most when billing for this type of appointment. Reimbursement for this code and those within its set of codes really became popular back with the Affordable Care Act’s long-awaited inclusion of mental healthcare in 2006.

CPT Code 99215 can be used for a high level of complexity appointment, and it is only used in 5% of visits. CPT Code 99215 is a level five code that should only be used for an patient with an established history. Billing with this code could produce up to 25% more in reimbursements that CPT Code 9214. However, attempting to bill with this code when it does not apply could welcome in audits. But, there is absolutely no reason not to bill with CPT Code 99215 when the situations warrants it. This is why understanding the regulations is very important in so many ways.

 

Who can bill with CPT Codes 99214 and 99215?

All sorts of medical professionals have the ability to bill with CPT Codes 99214 and 96215. The really wonderful news in this scenario is that clinicians practicing as other than mental health providers or therapists still have great success in billing with both of these codes.. Behavioral health assessments can used as extremely important tools in all sorts of healthcare settings, including primary care, cardiology and more.

Let’s look at a simple example of a cardiologist using CPT Code 99214. A patient may have a routine appointment for a heart healthy checkup. During the office visit, the patient may begin to describe the feelings of anxiety that he/she feels when pressure on the chest is experienced. Sometimes this may turn what began as momentary heart spasm into a full-blown anxiety attack. Upon hearing this account, the cardiologist may then decide to set a referral in motion for the patient to see a mental health professional to address the anxiety, as that it could have a direct impact on the patient’s health. Standardized assessment tools for anxiety (e.g. PHQ-9) may also be used to try to gather more information and analyze the severity of these emotions.

An easy-to-understand example of a physician using CPT Code 99215 the scenario of a young woman who is experiencing some health problems after a surgery on her thyroid. This patient is also experiencing chronic back pain for the last three years due to a slip-and-fall accident, and she is being treated with muscle relaxants. There are also feelings of depression associated with the pain and the after effects of the surgery. Behavioral assessment tools can be used to monitor the depression, as well as to utilize for deciding a course of action. The physician may set up a referral for therapy or a support group.

 

What procedures are there for billing CPT Codes 99214 and 99215?

For billing with CPT Code 99214, there must be two out of three components present for the correct billing of Code 99214. These necessary factors are:

 

  • A detailed interval history
  • A detailed examination
  • Moderate complexity medical decision making

 

A mix of two out of three of these components is required to bill for CPT Code 99214 must be utilized in face-to-face time of at least 25 minutes with the patient. The reasons for the visit are typically of a moderate to high complexity.

The conditions that must be present for CPT Code 99215 billing are also outlined in a simple manner. While the factors differ between codes, there must be two out of three of the following components:

 

  • A comprehensive history
  • A detailed examination
  • High complexity medical decision making

 

There must be a mix of these three components, along with 40 minutes of face-to-face time with the patient. The problems discussed during the appointment are typically considered to be of a higher severity.

The detailed or comprehensive history of the patient can be gained through thorough examination of the patient’s charts and records. However, this information can also be gained through mental health assessment tools. This can also be most helpful in understanding if any health problems could be further intensified by mental health conditions.

Remember that detailed exams are not always included in decision making. This could simply be a referral to see a specialist (e.g. a psychologist or a psychiatrist), a new prescription or a change in diagnosis.

 

How often can testing be billed with CPT Codes 99214 and 99215?

When the patient in questions require moderate to high levels of care during the appointment, billing for this care is very important. CPT Codes 99214 and 99215 may be billed according to time spent with the patient at each scheduled appointment. Not only will clinicians be able to bill at higher levels, but they can utilize behavioral assessment tools to discover and measure mental health conditions that could be present.

 

How much are reimbursements for screenings billed using CPT Codes 99214 and 99215?

When billing with CPT Codes 99214 and 992, face-to-face time spent with the patient during the visit is the basis for the reimbursement. Behavioral assessment instruments are also included as one of the tools to be used during the appointment. To get an idea of the monetary difference between the two codes, a major national healthcare insurer’s policies list CPT Code 99214 as reimbursable for up to $107.20 for each patient. With the same insurer, CPT Code 99215 is reimbursable for up to $144.80 for each patient.  This represents a difference of over $37 for each appointment with each patient. This is but one of the reasons that it is so important to understand the differences between billing CPT Codes 99214 and 99215.

 

Where can I find standardized screening instruments to use with CPT Codes 99214 or 99215 for behavioral assessments?

Mentegram has a library full of online tools, such as the PHQ-9. These tools can be utilized as sliding scales or questionnaires to assess mental health conditions. This can increase the factors of billing with higher complexity codes (e.g. billing CPT Code 99215 instead of 99214). But the benefits don’t stop there! Clinicians using these tools can also reduce and even replace paperwork, as well as save time with patient intake and monitor their patients, even in between appointments.

 

What are the most important things to remember about differentiating between CPT Codes 99214 and 99215?

  1. Always note the difference between the components that are required for each code to bill that particular complexity.
  2. Ensure that medical necessity is present during the moderate to high level care.
  3. Check your information to be certain that the documentation supports the level of care that is being billed.

So, are you ready to start billing with CPT Codes 99214 and 99215, as well as with other codes today?

 

Find more detailed information on how to bill with CPT Codes, while increasing your practice’s revenue. Read our additional articles on CPT Code 96127 and CPT Code 96103, plus comparisons between CPT Codes 99213 and 99214:

 

CPT Code 96127 – Answers to the frequently asked questions about billing this code

CPT Code 96127 – How to Increase Revenue with This New Behavioral or Emotional Assessment

3 Online Screenings That Can Be Billed with CPT Code 96127

How to Increase Revenue and Bill with Psychological Testing – CPT Code 96103

CPT Codes 99212 and 99213: Decide Which Code to Use for Behavioral Assessment Billing  

CPT Codes 99213 and 99214: Behavioral Assessment Billing

 

 

 

DISCLAIMER: Please keep in mind that Mentegram is a healthcare technology company, and do not consider content on our website as legal advice. It is your responsibility to decide to act on this content, relinquishing Mentegram of all claims. The information that we share is based on what has been effective  for our customers and the best practices as published by authoritative sources.
For specifics regarding your individual practice and specific cases, please consult the particular insurance companies or your office’s billing consultant for additional information.

 

 

SOURCES:

http://thehappyhospitalist.blogspot.com/2013/09/99214-CPT-Procedure-Code-Description-Examples-RVU-Distribution.html

https://www.cgsmedicare.com/partb/mr/pdf/99214.pdf

http://bh.medicaid.ohio.gov/Portals/0/Users/008/08/8/Coding-Documentation-for-Behavioral-Health-2016-Zucker.pdf?ver=2016-06-01-182611-063

http://www.mdedge.com/jfponline/article/63368/practice-management/10-billing-coding-tips-boost-your-reimbursement

https://www.cgsmedicare.com/partb/mr/pdf/99213.pdf

http://www.hcca-info.org/Portals/0/PDFs/Resources/Conference_Handouts/Clinical_Practice_Compliance_Conference/2010/Sun/P3_BrembyFriedelPPT-PDF.pdf

https://emuniversity.com/Level3EstablishedOfficePatient.html

http://www.medicarepaymentandreimbursement.com/p/medicare-fee-schedule-for-office-visit.html

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CPT Codes 99212 and 99213: Decide Which Code to Use for Behavioral Assessment Billing

What is it, who can bill for it and who will reimburse it?

Both of these Current Procedural Terminology (CPT) Codes belong to a set of codes (99211-99215) used for billing. They are all part of HCPS, the Healthcare Common Procedure Coding System. These codes can be used to bill for established patients who are being treated in an office environment for both or either medical or mental health conditions.

Some healthcare providers may find it a bit difficult to decide when to bill for these two codes. CPT Codes 99212 and 99213 may be part of this same family of codes, but the regulations that need to be followed for reimbursement are very different. One code requires more time with the patient than the other, so it is very important to know which code to use for billing. This also ensures that clinicians who are billing with either of these codes will be reimbursed fully.

Some providers bill for CPT Code 99212, when they could actually be billing with the higher reimbursable CPT Code 99213. To be sure that the billing code corresponds correctly with the office visit, let’s look a bit closer at the details and regulations associated with each code.

 

What exactly are CPT Codes 99212 and 99213?

(Change to 99212) CPT Code 99212 can be billed for the third highest level in care during the patient’s visit. CPT Code 99212 is a level two code. It must be billed with an established patient, not as a new patient visit of any form. The visit should be conducted in an outpatient atmosphere or as an in-office visit. Though the revenue for this code is not as high as with CPT Codes 99213 and 99214, it is widely used, especially as that it does not require a review of systems (ROS). Since the inclusion of mental healthcare in the Affordable Care Act in 2013, attention has been drawn to this code and those within the same family of codes for reimbursements.

For CPT Code 992213, an outpatient or inpatient office visit that is considered to be a mid-level visit can be billed with this code. CPT Code 99213 can only be used for an already established patient. It is a level 3 code. The patient must have a medical history. Yet, it should be no surprise to see that this code is very popular. In fact, among middle-level billing codes, it is the second most used. Many clinicians find that they are more successful when billing with this code than with some of the higher-level codes.

 

Who can bill with CPT Codes 99212 and 99213?

CPT Codes 99212 and 99213 can used for billing by all sorts of medical professionals who are wanting to assess a patient’s behavior. But keep in mind that even though it is commonly used for behavioral assessments, it is used by a larger variation of clinicians than just therapists or psychiatrists. Behavioral health assessments can be utilized in a large number of healthcare environments, most commonly by primary care physicians.

When you think of a primary care doctor using CPT Code 99212, let’s look at a simple scenario. A patient with existing history has an office visit for a routine health examination for a prescription refill for chronic pain. Often, when patients are experiencing chronic pain, they may also have feelings associated with depression. In this case, standardized assessment tools for depression (e.g. PHQ-9) may be used by the physician to gain more information. This can help determine if the patient that can be prescribed by the physician. Or, perhaps a referral is in order.

An example of a physician billing with CPT Code 99213 could be an existing patient that has scheduled an appointment for neck pain. Maybe has been occurring for several years. The patient could possibly be using anti-inflammatories and muscle relaxants. The patient may also be treating anxiety associated with this pain with a low-dose anxiolytic medication. During this visit, there are no new medications prescribed for any other ailments, and the diagnosis remains the same. In this case, behavioral assessment tools may be used by the physician to make sure that the anxiety levels have not worsened since the previous visit.

 

What procedures are there for billing CPT Codes 99212 and 99213?

It is very important to understand the regulations for billing with CPT Code 99212. Two out of the three factors below must be present if the clinician hopes to bill with CPT Code 99212. These required components should include:

 

  • A problem-focused interval medical history
  • A problem-focused exam
  • Medical decision-making that is very simplified and straightforward

 

Two out of three of these components are a requirement when billing necessary for CPT Code 99212. Plus, the face-to-face time spent with the patient must total at least 10 minutes. The reasons for the medical visit are usually of a mild complexity.

When using CPT Code 99213, it is also equally as important to understand the necessary components for billing. However, it is required to have two out of three of the these components:

 

  • An expanded history that is problem focused
  • An expanded exam that is problem focused
  • Medical decision-making that is considered to be of a low complexity

 

Any two of these three components will allow a clinician to use CPT Code 99213 for billing. However, there must also be a total of 15 minutes of face-to-face time experienced with the patient during the visit. The reasons for the visit must be considered low to moderate in severity.

Most clinicians easily recognize what is required for the detailed or expanded exams. However, the history and decision-making requirements are not always achieved so easily. Yet, adhering to the requirements and documenting along the way can be very simple, as long as the stipulations are followed.

For example, the detailed or expanded history can be documented simply by viewing the charts of the existing patient in question. Another easy way to gather this information is through assessments. Using mental health assessment tools during the visit to reveal underlying causes for a health condition is an excellent method.

The decision making process can include a consultation with a specialist (e.g. a psychologist or a psychiatrist). It can also include deciding whether to carry on with an existing prescription plan.

 

How often can testing be billed with CPT Codes 99212 and 99213?

When the complexity of the visit is discovered, the healthcare professional may then move forward with an examination that can be reimbursed through the appropriate billing codes. CPT Codes 99212 and 99213 may be billed for each patient during each session in accordance with the time spent, as long as the regulations for billing requirements are met. What this means for healthcare providers is that not only will they be able to bill for behavioral assessments, but they will be able to offer a level of mental healthcare to patients who may not be receiving this elsewhere.

 

How much are reimbursements for screenings billed using CPT Codes 99212 and 99213?

When billing with CPT Codes 99212 and 99213, the monetary amounts for billing are based primarily on the actual time that is spent with the patient during the visit. This will also include the use of behavioral assessment tools. Let’s look at a major national healthcare insurer’s policies, which allows CPT Code 99212 to be reimbursed up to $43.10 for each patient. With the same insurer, CPT Code 99213 can be reimbursed up to $72.70 for each patient.  That is a difference of nearly $30 for each patient billing under CPT Codes 99212 and 99213. Can you see how that can add up quickly?

 

Where can I find standardized screening instruments to use with CPT Codes 99212 or 99213 for behavioral assessments?

Mentegram has a library full of online tools, such as the PHQ-9. These tools can range from simple surveys to more-detailed questionnaires. Plus, they can even be administered on a tablet in the waiting room. However, using these tools can be used to increase the complexity level of the patient’s visit. In turn, it will allow the clinician to bill for the appointment using a higher code (e.g. billing CPT Code 99213 instead of 99212). Furthermore, these tools can even be used to reduce and even replace paperwork. This can save extremely valuable time in not only assessing the patient for behavioral health, but in patient intake and monitoring between office visits.

 

What are the most important things to remember about differentiating between CPT Codes 99212 and 99213?

  1. Above all else, be certain to adhere to the difference in the components for each code that must be present to allow for billing that specific code.
  2. Ensure that  medical necessity is the reason behind changing the complexity of the office visit.
  3. Make sure that all documentation is supported by the level of care that the clinician is billing for.

Don’t hesitate to ask us how you can start billing with CPT Codes 99212 and 99213, along with a variety of other codes!

Would you like more information on how to to bill with other codes and increase your practice’s revenue? Be sure to read our articles on CPT Code 96103, CPT Code 96127 and a comparison between CPT Codes 99213 and 99214:

How to Increase Revenue and Bill with Psychological Testing with CPT Code 96103

CPT Code 96127 – Answers to the frequently asked questions about billing this code

CPT Code 96127 – How to Increase Revenue with This New Behavioral or Emotional Assessment

3 Online Screenings That Can Be Billed with CPT Code 96127

CPT Codes 99213 and 99214: Behavioral Assessment Billing  

CPT Codes 99214 and 99215: Choosing Between These Codes for Behavioral Assessment Billing

 

DISCLAIMER: Please keep in mind that Mentegram is a healthcare technology company, and do not consider content on our website as legal advice. It is your responsibility to decide to act on this content, relinquishing Mentegram of all claims. The information that we share is based on what has been effective  for our customers and the best practices as published by authoritative sources.
For specifics regarding your individual practice and specific cases, please consult the particular insurance companies or your office’s billing consultant for additional information.

 

SOURCES:

http://bh.medicaid.ohio.gov/Portals/0/Users/008/08/8/Coding-Documentation-for-Behavioral-Health-2016-Zucker.pdf?ver=2016-06-01-182611-063

https://www.cgsmedicare.com/partb/mr/pdf/99213.pdf

http://www.hcca-info.org/Portals/0/PDFs/Resources/Conference_Handouts/Clinical_Practice_Compliance_Conference/2010/Sun/P3_BrembyFriedelPPT-PDF.pdf

https://emuniversity.com/Level3EstablishedOfficePatient.html

http://www.medicarepaymentandreimbursement.com/p/medicare-fee-schedule-for-office-visit.html

https://www.palmettogba.com/Palmetto/Providers.Nsf/files/Video_Part_B_CPT-Codes-for-Evaluation-and-Management-Office-Visits-Established.pdf/$File/Video_Part_B_CPT-Codes-for-Evaluation-and-Management-Office-Visits-Established.pdf

http://www.aafp.org/fpm/2007/0100/p21.html

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The Evolution of Therapy: 3 Big Changes That Are Implementing Better Mental Health Practices

Therapy… it’s that one word that can mean so many different things to so many different people. To some, it stands for that one hour a week where they can reclaim their lives and work to become the people that they truly want to be. For others, it takes on an almost mysterious aura, representing an experience that they don’t quite understand, but would love to try.

Whatever therapy might mean to you or what you might think it entails, the one thing that many people should be able to agree on is that the popular attitude toward it is changing. While the processes and routines have surely remained pretty much the same for decades, a resurgence has definitely begun. Therapy is no longer something experienced in secret, with a stigma of shame or uncertainty attached to it. With celebrities like anyone from the British royal family to Lady Gaga becoming champions for mental health, it is no longer something discussed in a whisper amongst only the closest of friends.

So, with more and more people embracing therapy and other mental health programs, therapists are finding that they need to find ways to see more patients in a day and to become more efficient in their practices. They must also ensure that once new patients take the leap and begin therapy, that they stay engaged and continue to experience gratification in their sessions.

Let’s look at three changes that therapy is undergoing to accommodate both its patients and its providers.

 

Patient Engagement

Now that some of the stigma often associated with mental health disorders has lifted due to raising awareness, therapists may find that there is a rise in patients who have never experienced a therapeutic setting before. But now that these patients are finally receiving the therapy that they need, it is even more important than ever before to ensure that they, as well as long-time therapy patients, stay engaged in between their office visits.

This is where new technology steps in and offers patient engagement solutions. A patient can download an app to their smartphone or tablet, allowing them to track their anxiety, depression or other disorder through a variety of sliding scales and surveys. This information is then sent directly to the therapist, who can process this to determine a course of action for their next visit. This is a win-win for both the patient and the clinician, as that the patient is reminded of their therapy in between visits, and the therapist is provided with additional information to assist them in providing even better, more informed care.

     

Practice Efficiency

As more and more people begin mental health treatment, therapists are finding that running their practice like a well-oiled machine is not only ideal, but an absolute necessity. And if they can find a way to fit in just one more patient each day, they are definitely doing their part in providing mental healthcare to the people who may need it the most.

However, there are only so many hours in a day, right? How can therapists possibly carve out enough time to see one additional patient?

Once again, technology arrives to save the day. Therapists can learn to take better therapy notes with software and use scheduling calendars for their appointments. And while it may have seemed like something from the future a few years ago, they can now also utilize video sessions, so that a patient never has to miss an appointment.

When a patient arrives in the office, they must also complete their intake, which can take quite a few minutes of administrative time. But patients may now complete their intake from a kiosk or a tablet in the office, as well as use mental health assessment tools to monitor their therapy or screen for other mental health triggers.

 

Integrated Care

Integrated care is when two healthcare options work together to provide an even higher level of care for patients. The two most commonly recognized are physical and mental healthcare. As you can imagine, this healthcare model is growing popularity, and it continues to provide more positive outcomes than traditional healthcare models.

Imagine that there is a patient in need of mental healthcare, but they have not been screened by a healthcare provider to even know that they are suffering. Or what is there is no available therapist in the area, due to either a long waiting list or geographical restraints? Sadly, in the past, these patients may have gone without treatment. However, as integrated care is introduced to more communities, and more primary care physicians set up successful integrated care, the number of patients who do not have access to mental healthcare will decrease.

Finally, the time has come when therapy is being embraced by a culture that has realized its importance. In the days ahead, it will be exciting to see how more new technological advances and an even heightened sense of awareness will alter therapy as we know it today. If we hold on for the ride and embrace new ideas that can be both more efficient and beneficial, we will have the opportunity to provide BETTER mental healthcare to even MORE patients than ever before. Can we really ask for a more positive outcome?

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CPT Code 96103: How to Increase Revenue and Bill with Psychological Testing

What is it, who can bill for it and who will reimburse it?

What exactly is CPT Code 96103?

CPT Code 96103 has been used since 2006, so it isn’t brand new. However, the Affordable Care Act included mental healthcare in insurance plans across the country back in 2016. So, CPT COde 96103 began seeing quite a bit more usage. CPT Code 96103 is a code that may be used to report reimbursements for psychological testing. This includes the extremely popular PHQ-9 scale. This testing must be administered through the use of a computer. Then the analysis of the testing and the final report must be supplied by a certified healthcare professional.

The good news is that the certified professional overseeing and interpreting the testing does not need to be a mental health provider. Some examples of these professionals may include: physicians, nurse practitioners, clinical nurse specialists, physician assistants, physical therapists, speech pathologists and a variety of other healthcare providers.

Who can bill with CPT Code 96103?

A large majority of healthcare professionals can bill with CPT Code 96103. It is not only for therapists and mental healthcare providers. Psychological testing can be utilized in a variety of medical settings. This includes in pain management care when a patient is in severe, chronic pain, in health clinics looking for the initial signs of mental health disorders and in senior care, when discerning the patient’s ability to make decisions related to their health.

What procedures are there for billing CPT Code 96103?

This is relatively simple, without a long list of requirements. Often, patients who are experiencing ongoing medical problems can be the most at-risk for developing mental health disorders. Therefore, the main requirement for psychological testing is that it can be deemed medically necessary, with the suspicion of a mental health condition. Once this has been ascertained, the testing must be conducted by a computer. Then the results must be measured by a healthcare professional, who will also provide a detailed report.

The computerized testing code 96103 is not a time-based code. It can be used once per session, regardless of the number of test instruments utilized.

How often can testing be billed with CPT Code 96103?

Imagine how nice it would be to not only save administrative time by using standardized testing, but to be able to regularly bill them for the patients that they can benefit! CPT Code 96103 may be billed one time for each patient during a session, making use of any number of testing assessments. So, not only will clinicians have more efficient practices by utilizing these screenings, but they can also use them to build revenue.

How much are reimbursements for screenings billed using CPT Code 96103?

Billing with CPT Code 96103 is a flat fee up to $28 for each patient. This is billed as one service to the patient, regardless of how many tests are actually conducted during that session. This fee is also inclusive of analyzing and reporting the testing by a healthcare professional.

Who reimburses billing using CPT Code 96103?

CPT Code 96103 is reimbursed by many major insurance companies. These can include:  Cigna, Humana, Aetna, Anthem and Medicare.

Where can I find standardized screening instruments to use with CPT Code 96103?

Mentegram has a library full of online tools that range from detailed surveys to simple sliding scales that can be used to bill with CPT Code 96103, including the PHQ-9. Mental healthcare providers may also use these tools to help reduce and even replace paperwork. This can save valuable time in administration by screening the patients and monitoring their progression, even in between appointments.

Ask us how you can start billing with CPT Code 96103 and other codes today!

For more information on other ways to bill and increase your practice’s revenue, check out our articles on CPT Code 96127:

CPT Code 96127 – Answers to the frequently asked questions about billing this code

3 Online Screenings That Can Be Billed with CPT Code 96127

CPT Code 96127 – How to Increase Revenue with This New Behavioral or Emotional Assessment

DISCLAIMER: Please keep in mind that Mentegram is a software company, and do not consider content on our website as legal advice. It is your responsibility to decide to act on this content, relinquishing Mentegram of all claims. The information that we share is what has worked well for our customers. It is also curated content of the best practices from authorities. We don’t consider ourselves billing consultants and experts. If you aren’t sure, please consult the particular insurance company or billing consultant for additional information.

SOURCES:

http://www.cognitrax.com/Manuals/CognitraxReimbursementGuide.pdf

http://www.healthpsych.com/tools/pearson_billing_2008.pdf

http://www.medicalbillingcptmodifiers.com/2012/08/96101-96120-sychological-and.html

https://downloads.cms.gov/medicare-coverage-database/lcd_attachments/31990_1/l31990psych017cbg040112.pdf

https://www.supercoder.com/my-ask-an-expert/topic/for-96103-who-is-considered-qualified-professional

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Milan Steskal

NEW: Quick Patient Assessment Through Mentegram Dashboard

One of our goals is to help you, as clinicians, to improve your productivity. I’m sure that you don’t want to spend too much time on paperwork. Who does, right? Assessing your patients’ mental health conditions without Mentegram usually involves paper, manual scoring and wasting 5 to 10 minutes that you could spend working with the patient.

Read more

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5 Ways to “Spring Clean” Your Therapy Practice

When the flowers begin to bloom and the temperatures begin to rise, many turn to the idea of spring cleaning. Now, when you think about your therapy practice, I’m not talking about grabbing a mop or dusting those shelves in the storage room. I’m referring to an organizational cleanse!

When your days grow longer and your patient list continues to multiply, it may be hard to find a few hours here and there to really make important changes that could completely streamline your office. However, as spring is ushered in, let’s take a look at a few ways to take part in this seasonal tradition to make your environment much more efficient.

 

1. Go Paperless

Whenever I think about the best way to really de-clutter a therapy office, my mind always goes to those stacks of paper that are constantly piled up on everyone’s desks. Not only can going paperless save you a good chunk of money AND make organization a breeze, but it can also be good for the environment! Stop printing off those emails and other unnecessary documents! Instead, keep them stored for easy access on a variety of apps, like Google Drive or OneDrive, where they can even be used on your smartphone. You may also want to invest in a good scanner and begin storing your older records digitally. Even more importantly, look into an EHR software. Finally, set up a recycling system and be ready to ditch that paper for good!

 

2. Find Better Ways to Screen Your Patients

Screening patients is such an important task in a therapy office! Therefore, it is imperative to have a streamlined process for asking the right questions and evaluating the answers in an efficient manner. If you’re still using a PHQ-9 in a paper format, check into using digital tools instead. Not only will you be adhering to the suggestions in tip #1, but your patients will love being able to access questionnaires and surveys right from their smartphones. You can also set up a kiosk in your waiting room with a tablet! Really… how cool is THAT?

 

3. Think About New Policies for Time Management

A  therapy practice is constantly changing. This means that you may need to occasionally re-evaluate your policies and adapt to new ideas that will save you time. For example, you may find that the number of missed appointments are on the rise. So be sure to incorporate ways to ensure that no-shows don’t leave you with an empty waiting room. A good digital practice calendar can assist with time management and scheduling appointments. It may also be part of a package that includes options for billing patients. And better yet, it can also send patients reminders, so those missed appointments will soon be last year’s problem!

         

4. Take Better Therapy Notes

If there is one thing that can keep a therapist in the office past dinner, it is typically finishing up the day’s therapy notes. However, gone are the days of taking notes by hand. Now you can replace the notepad and pen with sleek software and organizational perks that may save you 30 minutes every day. The best therapy notes software offers a variety of templates to choose from, even allowing you the option to completely customize your note-taking experience. You’ll never look at taking therapy notes the same way ever again!

 

5. Introduce Video Sessions

Dreaming about hosting therapy sessions online would have seemed like some type of futuristic scenario even a couple of years ago. However, technology has really armed therapists with a myriad of options to ensure that they are providing the best possible care for their patients. Setting up HIPAA compliant video sessions for your practice can ensure that your patients have a reliable, convenient alternative to in-office appointments. Plus, video sessions are commonly offered as an additional feature of therapy notes or EHR software, so there’s no need to download anything else! Could they make it any easier?

 

You know what they say about spring cleaning. Not only does it clear the cobwebs from your office, but it removes the clutter from your mind, as well.  This makes room for the important things in life. If you follow these easy steps, you’ll be able to open your windows for a nice spring breeze, put your feet up on your desk and embrace this newly found feeling of well-being that accompanies the satisfaction of a clutter-free existence. Who knew it was THIS easy?

 

Want more information on organization, going paperless, video sessions and therapy notes? Check out some of our similar topics for even more helpful information!

 

6 Steps for Writing Notes During Online Therapy

 

5 Easy Steps to Having a Paperless Practice

 

How To: HIPAA Compliant Video Conferencing With Mentegram Notes

 

NEW: Introducing Electronic Billing in Mentegram Notes

 

3 Steps to Make No-Shows a Thing of the Past
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5 Things Primary Care Physicians Need to Do to Set Up Successful Integrated Care

The topic of integrated care as a healthcare model for primary care physicians seems to come up more and more. Integrated care, also known as collaborative care, can best be described as the blending together of two types of care. These are primarily physical and mental healthcare. This worldwide reform offers new arrangements and forms of office organization. Patients will be able to expect a more complete experience, especially when mental healthcare options are not always readily available in their area.   

Primary care settings everywhere are implementing integrated health as the best possible scenario for seamless care. The end result is that this produces a solid, positive outcome.

However, there is a process involved to welcome in collaborative care. There are even some barriers to overcome so that this new model is successful in each ideal situation. Let’s take a look at five things that primary care physicians (PCPs) should do in order to streamline the introduction of this care into their offices.

 

1.) Seek Education on the Integration

Learning how to address mental health disorders is only the tip of the iceberg when it comes to introducing an integrated behavioral health practice into primary care. This is why programs are available, so that physicians, nurses and other office staff are brought up to speed on the objectives that must be met.  This educational effort ensures that they are equipped to manage an integrated practice.

 

2.) Set Aside Time in the Office Visit

Most primary care physicians have a routine with their patients during their scheduled office visits. However, if a good collaborative model is what the PCP is after, time constraints may need to be re-evaluated. To really go after successful patient outcomes, it is extremely important to allow for extra time.  This allowance will be dedicated to mental healthcare during examinations and consultations.

 

3.) Learn How to Ask the Hard Questions

Many primary care physicians are only used to asking exploratory questions like, “How are you feeling emotionally?” And unfortunately, a patient’s typical response is usually, “Fine”. This is mostly do, in part, to the stigma that is still associated with mental health disorders. However, when making strides toward integration, this interaction will need to be more than a casual question thrown in after “Are you still having those headaches?” Physicians will need to learn how to dig a little deeper, alert to signs that a mental health disorder may be present.

 

4.) Make Mental Health Screenings a Priority

When integrating a primary care office, nothing can be as important as utilizing the proper mental health screenings. Making use of digital tools, like the PHQ-9, will be imperative.  This will assist PCPs with finding the required answers to the right set of questions. Using software to screen patients will also cut down on the administrative time needed. Patients can easily fill out the surveys from their own smartphone. Some offices may even offer the convenience of a kiosk in the waiting room.

 

5.) Become Successful in Scheduling Outpatient Mental Health Services

A barrier that many primary care physicians run into is the lack of mental healthcare professionals in their areas. When it becomes fairly obvious that a patient requires a level of mental care that would not be available in a primary care setting, being able to make that referral should not stand in the way of what the patient needs. However, this is exactly why integrated healthcare is becoming so popular. It is often the only way to present mental health services to a patient in a particular area, without complete lack of access or a long waiting period. But it is also important to make sure that the PCP has resources available to provide outpatient options, should it be necessary. Online counseling services like BetterHelp may be a great way to start.  This will be especially helpful if you don’t already have a mental health professional in your practice.

 

Mentegram already has a few success stories with customers who are currently incorporating integrated care. Most are also introducing mental health screenings into their practices. My Doctor Medical Group is located in San Francisco, and they specialize in providing primary care.  They also offer addiction treatment, urgent calls and other services vital to a patient’s recovery. Dr. Jennifer Banta, the Director of Behavioral Health, states, “Our integrated medical practice has been using Mentegram for about a month, and I am very excited about the early results with this self-tracking tool in more fully engaging patients in their own treatment.” For even more details, read more about these screening tools and her success from our recent article with Dr. Banta.

The more common integrating behavioral health practices with primary care becomes, the instances in which a patient truly needs mental healthcare and does not have access to it will decrease. Plus, with software like Mentegram, the face of mental healthcare will forever change. Concerns about bridging the gap between mental healthcare and the patient’s continued interest in treatment will become a thing of the past. Won’t that be a fantastic day?

 

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Psychiatry and Primary Care: More Closely Linked for the Future

Have you ever heard that old saying, “The more things change, the more they stay the same?” This definitely applies to the ever-fluctuating connection between psychiatry and primary care. As we see more and more therapy-related scenarios play out in primary care offices across the globe, there still seems to be a barrier.

Imagine a wide cavern, with therapists, psychiatrists and other mental healthcare professionals all on one side. On the other, envision physicians, nurses and administrative personnel who play numerous roles in ensuring that we all stay healthy. Yet, somewhere in the middle, wouldn’t it be fantastic if these two healthcare facets could assist one another? Could they achieve even more success in patient outcomes along the way?

At Mentegram, we can clearly see the type of bridge that needs to be built. Fortunately, more and more clinicians are realizing this as a reality in their own practices, as well. Yet, it is extremely exciting when major organizations not only recognize the changes that need to be made within the system, but they actively work to educate other professionals.

PsychU is a community that is made up of mental health professionals who are absolutely dedicated to the improvement of healthcare. In achieving this, they provide information, set up discussions and find innovative new ways for interested individuals to collaborate. In a recent webinar, they did just that.

Entitled “Bridging the Gap Between Primary Care & Psychiatry in the Treatment of MDD”, this webinar showcases three speakers (Venus Miller, MSN, ARNP, FNP-BC, PMHNP-BC, Roland Larkin, PhD, NP and Kimberly Lonergan, RN, MSN) who share their knowledge of the best ways to build a deeper connection between mental healthcare and primary care.

Even though many of us know the figures, sometimes seeing them filter across a presentation at a slideshow really sends the message home. Take a look at these percentages for illnesses that are accompanied by depression:

  • High blood pressure 24%  
  • Asthma 17%  
  • Diabetes 9%  
  • Heart Disease 7%  
  • Stroke 3%

On the other end of the spectrum, depression makes up 5 to 10% of the reasons people are seen at a primary care clinic. Yes, that’s right, seeing your PCP (primary care physician) is not just for flu symptoms or migraines! In fact, 79% of antidepressant medications are prescribed by a health professional, and 60% of people with depression are seen by a PCP.

The idea of seeing a primary care professional for mental health disorders will even be more successful depending upon the attitude of the physician and how the patient is responding to the care. However, there are a few things that are currently standing in the way of closing this gap.

 

Physicians

  • The attitude of the physician plays a key role in a successful outcome, especially how open they are to discussing mental health disorders. If a physician has a difficult time asking the hard questions, then the answers they receive will not paint a very clear picture.
  • The time that a physician has available for mental health issues will play a key role. If there’s only a moment for, “Hi, how are you feeling?”, then it will be extremely difficult to gather the information that is needed to set forth a treatment plan.
  • It is not only important to ask the right questions, but to document them in a way that saves everyone time, while still providing the patient a chance at the best care possible. The physicians must set a plan in motion that involves screening patients for mental health care problems, preferably with survey-style forms like the PHQ-9.

 

Patients

  • With patients, their failure to seek this kind of care normally pertains to the stigma that is often associated with reaching out for mental health assistance. It’s often an easier first step for the patient to ask their PCP a few questions about their anxiety, rather than sit down for a full session with a therapist.
  • Some patients have lack of access to such treatment. If it is not made available to them, then there can be absolutely no chance of a successful outcome.
  • The most difficult factor for some patients to overcome is their complete lack of awareness that there is a problem. Again, if they aren’t asked the questions, then they are never prompted to reflect upon their own mental health.

 

A survey shows that collaborative care within a primary care office works best when utilizing screening tools like the PHQ-9 and support provided by a care manager. When a patient has high blood pressure or heart disease, there are tests and tools used to gauge their responsiveness or the success of their treatment. It should be no different in mental healthcare, especially with the ability to use screening tools for depression and anxiety, like the PHQ-9.

Venus Miller, one of the webinar speakers, is a Family & Psychiatric Nurse Practitioner at SMC Medical Center in Miami and Infinite Behavioral Health in Hollywood, Florida. Her clinical areas of expertise include family and psychiatric medication assessment and treatment across the lifespan, as well as substance abuse disorders in dual diagnosis clients. Therefore, she is the perfect person to address the changes that could be coming down the pipeline in the mental healthcare industry.

Venus stated, “There’s no more time for not addressing this issue.” And she’s right. This is one of the most prolific statements made when looking at the urgency of bridging this gap between primary care providers and mental healthcare personnel.

As we strive toward a deeper connection between primary care and mental health, we must first look at what services are offered by the PCPs, and then decipher the best ways to conduct screenings to offer those services.

If you’re looking for  way for patients to be screened for mental healthcare disorders from the waiting room, with little or no administrative assistance, take a look at what Mentegram has to offer. Bridging this gap might not be as difficult as you might think.

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Milan Steskal
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Mentegram in Primary Care: Our Customer Story

Mentegram has started reaching outside of the pure mental health settings. The first customer is My Doctor Medical Group, a medical practice from San Francisco. They specialize in providing primary care, as well as addiction treatment, urgent calls and other services vital to a patient’s recovery. Their doctors, led by Dr. Paul Abramson who is the Medical Director, are also available to provide visits at home, at hotels, on location or even at your office. We asked Dr. Jennifer Banta, the Director of Behavioral Health, to share a few words on how Mentegram is working for My Doctor Medical Group.

Dr. Jennifer Banta“Our integrated medical practice has been using Mentegram for about a month, and I am very excited about the early results with this self-tracking tool in more fully engaging patients in their own treatment.

I have been a licensed psychologist for over a decade, and one of the biggest challenges in treatment is having patients continue to do the work of therapy when not in therapy. Follow-through on paper-and-pencil homework assignments tends to be inconsistent due to forgetting, misplacing assignments, and poor motivation. Workbooks are somewhat better at encouraging completion of work, however, they tend to be specific to one topic, and that is not ideal when we are treating complex cases that do not present only one problem.

Apps are also often specific to one problem (eg, weight loss), and I have found that the average patient has bandwidth for one or perhaps two apps at a time without fatiguing or burning out.

Mentegram has come along and provided a generous library of brief, patient-friendly interventions that span a broad range of common presenting problems across physical and emotional well-being. Moreover, we can create custom interventions tailored to our specific patients. We are finding our patients want to help design their intervention, adding affirmations to keep them focused, behavioral activation that is meaningful to them.

Research has shown us that ownership and engagement in a solution will lead to better outcomes, and our patients are now helping shape the solutions to their problems. I look forward to and fully expect that this will translate to improved treatment compliance, because our patients are now part of their treatment goals and design in an entirely new and empowered way.

Of 7 patients I had start tracking data on my caseload, 6 have tracked within the past week and 4 within the past 24 hours. I understand this is a small sample size, but it should also be meaningful to anyone who is in clinical practice. It is quite extraordinary, particularly given the rich significance and customization of the data we are collecting and using together with our patients to optimize their health and well-being.

I can’t say enough about the product support from Milan, the founder, and his team. Well done!”

Seeing how Mentegram keeps helping care providers and their patients in real-life situations makes me beyond excited. What I can say is that even though we are continuously applying our clients’ feedback to our new features, we are always here to do our best to help providers as they continue to take care of our physical and mental health, working as efficiently as they can.

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Milan Steskal
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Copy, save and delete templates in Mentegram

Instrument templates in Mentegram is one of the features that our customers love the most. The library of public templates provides you with over 40 instruments that you can use with your patients and clients in one click. The private library allows the clinicians and organizations the ability to create their own templates that they will use often. Assigning the instrument to the patient, getting answers and scoring them (in case of assessments like PHQ-9, for example) is so much faster than printing them and having to score them manually. I’m excited that we have made working with instruments even faster and easier. I believe that the recent updates will save you at least a few minutes every single day.

Read more

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