Coding
Mental Health Care for Under- or Uninsured Pediatric Patients
“Evaluating and treating mental health problems in under- or uninsured pediatric patients often presents more challenges, but it is even more rewarding when you are able to provide life-changing mental health care,” explains Natalie Robiou, MD, a pediatric primary care provider at a Federally Qualified Health Center (FQHC) in Philadelphia, PA. The number of pediatric…
Read MoreWhy Clinicians Should Consider Coding by Time for Mental Health Care
“Many primary care providers are still coding by medical decision-making for mental health care,” explains Eugene Hershorin, MD, a REACH faculty member and medical coding expert. “However, time-based coding is both easier and often results in higher coding levels and therefore higher payment rates, especially for pediatric patients who require ongoing care for mental health…
Read MoreNew coding guidelines for 2021
2021 brings big changes to coding for mental health visits in pediatric primary care! The new coding guidelines issued by the Centers for Medicare and Medicaid Services (CMS) reduce the documentation burden and increase the levels of payment (work relative value units or wRVUs).
Read More5 Tips on Coding for Mental Health in Primary Care
Some pediatric primary care providers (PCPs) are nervous about providing mental health services because they are not sure they can be paid. However much they may want to treat patients with mental health disorders, they can’t afford to practice for free! Evaluation and management of mental health conditions is time-intensive. PCPs wonder, “How can I spend 90 minutes doing intake?” Those who work in large healthcare systems worry about the WRVUs (work relative value units) by which their productivity is judged. Providers in small practices worry about getting paid for visits that involve primarily talk. “Primary care providers absolutely can be paid for mental health care,” said Dr. Eugene Hershorin, a coding expert in the Pediatric Department in the University of Miami Health System and a REACH Institute faculty member.
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