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Mental health billing

Behavioral Health or Mental Health is an important specialty that we have chosen to work with. We do full cycle Billing for Psychiatrists, Nurse Practioners, Therapists and Social workers offering services to their mental health clients. We have acquired extensive knowledge in Mental Health billing over the past 20 years and boast with some very strong recommendations.

We follow the regulations and best practices in Mental Health billing and adhere to CCI. Our Eligibility and Benefits verification process alerts our providers about the necessity to acquire pre-authorizations to use certain codes like 90837, and we maintain a log of the allowed and utilized units in an authorization.

We do In-Patient and out patient billing and in case of in-patient billing we track every patient from the Admit code to the follow-up codes and to the discharge code diligently, and make sure every visit is accounted for.

In an outpatient Therapy setting, we check the Eligibility of the Insurance every month to make sure the claims get processed on the first attempt.

Procedures performed by Behavioral Health Providers
90791 Psychiatric Diagnostic Evaluation This code is used for an initial diagnostic interview exam that does not include any medical services
90792 Psychiatric Diagnostic Evaluation with Medical Services This code is used for an initial diagnostic interview exam for an adult or adolescent patient that includes medical services
90832 Individual Psychotherapy 30 minutes with patient and/or family member
90833 Individual Psychotherapy 30 minutes with patient and/or family member
90834 Individual Psychotherapy 45 minutes with patient and/or family member
90836 Individual Psychotherapy 45 minutes with patient and/or family member
90837 Individual Psychotherapy 60 minutes with patient and/or family member
90838 Individual Psychotherapy 60 minutes with patient and/or family member
90845 Psychoanalysis Psychoanalysis is performed by therapists who are trained and credentialed to practice it
90846 Family Psychotherapy Without the Patient Present
90847 Family Psychotherapy Conjoint Psychotherapy (With Patient Present)
90849 Multiple Family Group Psychotherapy This code is used when the psychiatrist provides psychotherapy to a group of adult or adolescent
90853 Group Psychotherapy (Other Than of a Multiple Family Group) This code relies on the use of interactions of group members to examine the pathology of each
90865 Narcosynthesis for Psychiatric Diagnostic and Therapeutic Purposes This procedure involves the administration of a barbiturate or a benzodiazepine in order to suppress
90867 Therapeutic Repetitive Transcranial Magnetic Stimulation (TMS) initial treatment, including cortical mapping, motor threshold determination, delivery and management
90868 Subsequent TMS Delivery and Management Per session
90869 Subsequent TMS Motor Threshold Re Determination with Delivery and Management Per session
90870 Electroconvulsive Therapy Includes Necessary Monitoring; Single seizure
90875 Individual Psychophysiological Therapy Incorporating Biofeedback Training by any Modality face to face with the patient, With Psychotherapy (e.g., insight oriented, behavior modifying, or supportive psychotherapy); approximately 20 to 30 minutes
90876 Individual Psychophysiological Therapy Incorporating Biofeedback Training by any Modality face to face with the patient, With Psychotherapy (e.g., insight oriented, behavior modifying, or supportive psychotherapy); approximately 45 to 50 minutes
90880 Hypnotherapy Hypnosis is the procedure of inducing a passive state in which the patient demonstrates increased amenability and responsiveness to suggestions and commands, provided they do not conflict seriously with the patient’s conscious or unconscious wishes
90882 Environmental Intervention for Medical Management Purposes on a Psychiatric Patient’s Behalf With Agencies, Employers, or Institutions The activities covered by this code include physician visits to a work site to improve work conditions for a particular patient, visits to community based organizations on behalf of a chronically mentally ill patient to discuss a change in living conditions, or accompaniment of a patient with a phobia in order to help desensitize the patient to a stimulus
90885 Psychiatric Evaluation of Hospital Records, Other Psychiatric Reports, Psychometric and/or Projective Tests, and Other Accumulated Data for Medical Diagnostic Purposes Although this would seem to be a very useful code, because reviewing data is not a face to face service with the patient, and most of the insurance companies will not reimburse for this code
90887 Interpretation or Explanation of Results of Psychiatric, Other Medical Examinations and Procedures, or Other Accumulated Data to Family or Other Responsible Persons, or Advising Them How to Assist Patient Most of the insurance companies will not reimburse for this service because it is not done face to face with the patient, and clinicians should verify coverage by other insurers to ensure reimbursement
90889 Preparation of Report of Patient’s Psychiatric Status, History, Treatment, or Progress (Other Than for Legal or Consultative Purposes) for Other Physicians, Agencies, or Insurance Carriers Psychiatrists are often called upon to prepare reports about the patient for many participants in the healthcare system. This code would be best used to denote this service. However, because this is not a service provided face to face with a patient, most of the insurance companies will not reimburse for this code either
95970, 95974, 95975 Neurostimulators, Analysis Programming These codes have been approved for vagus nerve stimulation (VNS) therapy for treatment resistant depression
Office or outpatient services
New patient 99201 to 99205
Established patient 99211 to 99215
Hospital observational services
Observation care discharge services 99217
Initial observation care 99218–99220
Hospital inpatient services
Initial hospital care 99221–99223
Subsequent hospital care 99231–99233
Hospital discharge services 99238–99239
Consultations
Office consultations 99241–99245
Inpatient consultations 99251–99255
Emergency department services
Emergency department services 99281–99288
Nursing facility services
Initial Nursing Facility 99304–99306
Care Subsequent nursing facility care 99307-99310
Nursing facility discharge services Annual Nursing 99315–99316
Facility Assessment 99318
Domiciliary, rest home, or custodial care services
New patient 99324–99328
Established patient 99334–99337
Home services
New patient 99341–99345
Established patient 99347–99350
Behavior Change Interventions
Smoking and tobacco use cessation 99406-99407
Alcohol and/or Substance abuse structured screening and brief intervention 99408-99409