Collaborative Care Tips for Sustainability. Virna Little, PsyD, LCSW r, SAP The Institute for Family Health NYS Collaborative Care Initiative
|
|
- Maurice Simpson
- 8 years ago
- Views:
Transcription
1 Collaborative Care Tips for Sustainability Virna Little, PsyD, LCSW r, SAP The Institute for Family Health NYS Collaborative Care Initiative
2 Teamwork Applies to Billing Too!!! Combine with other initiatives where there may be dollars helpful for staff NCQA Gain Sharing Agreements PCMH ACO Health Homes DSRIP
3 Speaking of Teams Collaborative Care adds two new members to the primary care team Psychiatric Consultant Depression Care Manager
4 License Matters Article 28 FQHC Article 28 non FQHC Article 31 FQHC Article 31 non FQHC Dually licensed Physician Group
5 FQHC Providers Article 28 licensed PPS rate Can utilize social workers to bill for behavioral health services clinical services Up to 10,000 visits per location Ancillary to primary care ( referral) Short term treatment
6 Article 28 Non FQHC June 2011 Medicaid Update has details Bill for behavioral heath for designated populations Guidance may be to apply for Article 31 with waivers for shared space, records, DCM Same guidance for visits up to 10,000 short term and ancillary
7 Article 31 9 Dually licensed FQHC providers in New York Specialized mental health services Able to bill all codes for behavioral health APG rates except for FQHC providers who opted out of APG rates
8 Integrated License Currently a pilot project Potential ability for increased revenue for integrated licensure status Expected continuation in 2015 but unclear as to parameters or regulatory requirements Now must be already dually licensed Health, Mental Health and Substance Abuse
9 Depression Care Managers Social Worker LMSW or LCSW Licensed Counselors Nurse Practitioner RN Psychologist PhD or PsyD Who to hire for maximum revenue?
10 Depends on Setting and Payer Mix Review your payer mix Checks codes vs provider vs payer Develop a spreadsheet to determine where you might have reimbursement gaps DO THIS FIRST!!! (even if you are grant funded )
11 LCSW, LCSW r Recognized by Medicare Reimbursable by more plans More likely to be able to supervise students Higher salary than LMSW
12 LMSW Not recognized by Medicare however can Incident too bill Some plans will not recognize Requires some oversight Lesser salary
13 Nurse Practitioner Reimbursable with plans Medicare reimbursement Not good use of prescriber time to provide care management services that are not reimbursable Higher salary PST longer sessions vs. medication management sessions
14 RN Not reimbursable for most part Higher salary than social workers often Could be combined with provider visit for higher coding
15 Psychologists Masters level not reimbursable PhD and PsyD recognized by Medicare and most payers Higher salary Able to supervise interns /trainees
16 Counselors Not recognized by Medicare Not recognized by all payers Diagnosing Salary equal to Social Workers LMSW range Only able to bill in Article 31 centers
17 Psychiatric Consultants Reimbursable for direct care Review payer mix and reimbursement to determine number of patients for viability Consultation not reimbursable unless joint visit and can by higher code ( 99214)
18 Behavioral Health Billing First time for many organizations Codes in contracts Process for authorizations Professional appointment Credentialing Codes in system Trained providers for billable notes
19 Psychosocial Assessment Same definition: History (social, psychiatric, medical, substance, etc.) Mental status Assessment of symptoms Same documentation Does not include psychotherapy! Face to face Article minute minimum
20 Psychotherapy PST Visits Article 31 minimum 30 min Article to 37 minutes Few Visits Article 31 minimum 45 minutes Article to 52 minutes Groups Article 31 minimum 60 minutes Min 2 max 12 Article minutes
21 Not all DCM Services Billable Care management for the most part unless done under some agreement Same day services often not reimbursable Warm hand off many times not billable because of duration, content and being same day however may work in favor for show rates for next visit
22 Viability of Depression Care Managers Diversity of visits is a good thing but often makes business plans a struggle Productivity does not paint a full picture and often limits access Capacity is better measure counting actual time in patient care
23 HBAI Codes CPT codes adopted in 2002 to address primary-carebased BH services delivered in coordination with PCP services. DEPRESSION CARVED OUT Adopted by Medicare Not opened by PA Medicaid and private sector adoption is spotty; check contract Mauer, National Council Community Behavioral Healthcare, 2006
24 Telephone Consultation Not traditionally covered by payers Can be completed by physicians and qualified non physician providers Must be established patient or collateral Can t be within 7 days following an appointment or prior to next appointment 98967: minutes of medical discussion 98968: minutes of medical discussion 98966: 5 10 minutes of medical discussion
25 CPT Codes for Medical Case Conferences Medical team conference with interdisciplinary team of health care professionals, face to face with patient and/or family, 30 minutes or more, participation by non physician qualified health care professional Medical team conference with interdisciplinary team of health care professionals, patient and/or family not present, 30 minutes or more participation by physician Participation by non physician qualified health care professional.
26 Documentation for Case Conferences Each participant should document participation in team conference Documentation should include contributed treatment recommendations Documentation should include role of individual in patient s care Documentation should include subsequent treatment recommendations
27 Who Reimburses for Depression Screening in Primary Care?
28 Medicare G0444 Healthcare Common Procedure Coding System Code (HCPCSC) Code to report screening for depression in adults Effective October 14, 2011 Reimburses for depression screening up to 15 minutes
29 The Affordable Care Act includes incentive payments through 2014 & requires a penalty beginning in 2015,for eligible professionals who do not satisfactorily report PQRS assessments. G0444
30 Medicare G0444 Appropriate for patients entitled to benefits under Part A and Part B Medicare coinsurance and Part B Deductible waived Needed for reporting claim, but Medicare does not require an ICD 9 CM diagnosis code for depression screening in adults
31 Medicare G0444: What is not covered Treatment options for depression Chronic conditions resulting from depression Therapeutic interventions: pharmacotherapy, combination therapy or other interventions for depression Depression screening more than once in a 12 month period
32 Depression in Primary Care Program Seeks to promote depression screening and monitoring within primary care Provides PHQ 9 for screening and monitoring depressed patients Offers reimbursement for depression screening and follow up
33 How to Trigger Reimbursement Claims must have the following billing combination: CPT code (administration and interpretation of a health risk assessment) Diagnosis code V79.0 (screening for depression)
34 Other Relevant Information Patients must have Aetna medical insurance; Aetna behavioral health coverage not required Providers need to be credentialed by Aetna Codes need to be included in organization s contract with Aetna Allowed up to three (3) initial visits in PCP office, a maximum of 30 minutes each
35 ITPC in Medicare Advantage Hierarchical Condition Category (HCC) Payment Methodology: HCC Code 55 (Depression) adds ~ $ 300 to monthly payment for Medicare Advantage patient Move from 311 coding to alternate code like Major Depressive Disorder
36
37 Questions Questions to
Planning Effective. Workflows & Payment Models
Planning Effective Collaborative Care Workflows & Payment Models Virna Little, PsyD, LCSW r, SAP TWO PROCESSES 1. Systematic diagnosis and outcomes tracking e.g., PHQ 9 to facilitate diagnosis and track
More informationThe Collaborative Models of Mental Health Care for Older Iowans. Model Administration. Collaborative Models of Mental Health Care for Older Iowans 97
6 The Collaborative Models of Mental Health Care for Older Iowans Model Administration Collaborative Models of Mental Health Care for Older Iowans 97 Collaborative Models of Mental Health Care for Older
More informationSIF and Sustainability
SIF and Sustainability Creating long term financial sustainability for IMPACT at your clinic Virna Little Diane Powers CNCS Social Innovation Fund Sustainability and scaling key to mission John A. Hartford
More informationNEW YORK STATE MEDICAID PROGRAM CLINICAL PSYCHOLOGY MANUAL POLICY GUIDELINES
NEW YORK STATE MEDICAID PROGRAM CLINICAL PSYCHOLOGY MANUAL POLICY GUIDELINES Table of Contents SECTION I - REQUIREMENTS FOR PARTICIPATION IN MEDICAID -------------------------------------------- 2 REPORTING
More informationFinancing integrated Healthcare in Washington
Financing integrated Healthcare in Washington as of: April 23. 2012 E & M Codes CPT Code 99201-99205 99211-99215 Est. Pt Diagnostic Code May be used only with physical Federally Qualified Health Centers
More informationFinancing integrated Healthcare in California
Financing integrated Healthcare in California as of October 12, 2012 E & M Codes CPT Code 99201-99205 ew Pt 99211-99215 Est. Pt Diagnostic Code May be used only with physical Federally Qualified Health
More informationConsolidated Project Information Project 3.a.i Integration of Primary Care and Behavioral Health Services
Consolidated Information 3.a.i Integration of Primary Care and Behavioral Services Contents 3.a.i Integration of Primary Care and Behavioral Services... 3 3.a.i Objective & Requirements... 3 3.a.i Requirements
More informationCPT Coding Update And Other Issues
CPT Coding Update And Other Issues Robert E. Smith, M.D. Alison Lynch, M.D. November 13, 2013 1 Disclaimer This information is for educational and informational purposes only, and represents the understanding
More informationMedicare & Incident To Billing for Mental Health Services
Medicare & Incident To Billing for Mental Health Services Under Medicare Part B, services may be provided by one healthcare practitioner incident to another Medicare-enrolled practitioner. This allows
More informationPsychosocial Rehabilitation Program Services
Psychosocial Rehabilitation Program Services 2013 Overview Objectives Definitions What it is not What it is Who can provide What to focus on Populations of Service Documentation Requirements 2 Objectives
More information2013 CPT CODE CHANGES for NYS OMH Licensed Clinics. New York State Office of Mental Health December 13, 2012
2013 CPT CODE CHANGES for NYS OMH Licensed Clinics New York State Office of Mental Health December 13, 2012 Background New Psychiatric CPT codes published by AMA Compliance mandatory under federal law
More informationTRANSITIONAL RESIDENTIAL TREATMENT PROGRAM Session Law 2007-323 House Bill 1473, Section 10.49(i)
REPORT TO THE THE JOINT LEGISLATIVE OVERSIGHT COMMITTEE ON MENTAL HEALTH, DEVELOPMENTAL DISABILITIES AND SUBSTANCE ABUSE SERVICES TRANSITIONAL RESIDENTIAL TREATMENT PROGRAM Session Law 2007-323 House Bill
More informationBilling Frequently Asked Questions
Billing Frequently Asked Questions What are the general conditions which must be met in order to bill for a service? All billed services except assessment must be medically necessary for the treatment
More informationPSYCHOTHERAPY: HOW TO GET STARTED
PSYCHOTHERAPY: HOW TO GET STARTED I didn t want to talk about my problems with someone I didn t know. Then I learned how common it is to initially feel hesitant and to even try several therapists before
More informationHB 159 mandates that private insurance provides the following for individuals diagnosed with Autism spectrum Disorders:
HB 159 mandates that private insurance provides the following for individuals diagnosed with Autism spectrum Disorders: "Applied behavior analysis" means the design, implementation, and evaluation of environmental
More informationInsurance 101. Infant and Toddler Coordinators Association. July 28, 2012 Capital City Hyatt. Laura Pizza Plum Plum Healthcare Consulting
Insurance 101 Infant and Toddler Coordinators Association July 28, 2012 Capital City Hyatt Laura Pizza Plum 1 Agenda Basics of Health Insurance Frequently Asked Questions Early Intervention and working
More informationMedicare Chronic Care Management Service Essentials
Medicare Chronic Care Management Service Essentials As part of an ongoing effort to enhance care coordination for Medicare beneficiaries, the Centers for Medicare & Medicaid Services (CMS) established
More informationProject Objective: Integration of mental health and substance abuse with primary care services to ensure coordination of care for both services.
Domain 3 Projects 3.a.i Integration of Primary Care and Behavioral Health Services Project Objective: Integration of mental health and substance abuse with primary care services to ensure coordination
More informationFrequently Asked Questions (FAQs) from December 2013 Behavioral Health Utilization Management Webinars
Frequently Asked Questions (FAQs) from December 2013 Behavioral Health Utilization Management Webinars 1. In the past we did precertifications for Residential Treatment Centers (RTC). Will this change
More informationDay Treatment Mental Health Adult
Day Treatment Mental Health Adult Definition Day Treatment provides a community based, coordinated set of individualized treatment services to individuals with psychiatric disorders who are not able to
More informationManaged Care Readiness Training Series: Revenue Cycle Management 2nd Learning Community Charge Capture and Coding
Managed Care Readiness Training Series: Revenue Cycle Management 2nd Learning Community Charge Capture and Coding Charge Capture and Coding Presenter: David Wawrzynek MS, MBA Managed Care Technical Assistance
More informationDivision of Behavioral Health. Requirements for Program Staff
Division of Behavioral Health Requirements for Program Staff Integrated BH Regulations Training 1 Program Staff Program Staff are professionals who render behavioral health services directly to a recipient.
More informationFAQs on Billing for Health and Behavior Services
FAQs on Billing for Health and Behavior Services by Government Relations Staff January 29, 2009 Practicing psychologists are eligible to bill for applicable services and receive reimbursement from Medicare
More informationUpdate January 2008. BadgerCare Plus Information for Providers. BadgerCare Plus Overview. Definition of the New Benefit. No.
Update January 2008 No. 2008-04 BadgerCare Plus Information for Providers To: All Providers, HMOs and Other Managed Care Programs Mental Health and Substance Abuse Screening, Preventive Mental Health Counseling,
More informationQuestions asked on SBIRT TA Webinar
Questions asked on SBIRT TA Webinar Housekeeping Could you send out the link to download the updated SBIRT guidance document? The updated SBIRT guidance document is available online here: http://www.oregon.gov/oha/pages/cco-baseline-data.aspx
More informationRHC TA Webinar/Call August 6, 2015
RHC TA Webinar/Call August 6, 2015 Proposed Medicare Policy to: 1. Allow Medicare payments for Chronic Care Management services provided by Federally Certified RHCs; 2. Mandate use of HPCPS/CPT codes on
More informationNew Hampshire Telemedicine Reimbursement Guide. Franconia Notch, New Hampshire
New Hampshire Telemedicine Reimbursement Guide Franconia Notch, New Hampshire The Northeast Telehealth Resource Center team is pleased to announce our 1 st edition of this Telemedicine Reimbursement Manual.
More informationNew Substance Abuse Screening and Intervention Benefit Covered by BadgerCare Plus and Medicaid
Update December 2009 No. 2009-96 Affected Programs: BadgerCare Plus, Medicaid To: All Providers, HMOs and Other Managed Care Programs New Substance Abuse Screening and Intervention Benefit Covered by BadgerCare
More informationBehavioral Health Providers Frequently Asked Questions
Behavioral Health Providers Frequently Asked Questions Q. What has changed as far as Behavioral Health services? A1. Effective April 1, 2012, the professional and outpatient facility charges for Licensed
More informationAssertive Community Treatment The Indiana Experience. Pat Casanova Director, Indiana Office of Medicaid Policy and Planning November 2009
Assertive Community Treatment The Indiana Experience Pat Casanova Director, Indiana Office of Medicaid Policy and Planning November 2009 Indiana ACT History 2001: Division of Mental Health and Addictions
More informationIntegrating Behavioral Health and Primary Health Care: Development, Maintenance, and Sustainability Cici Conti Schoenberger, LCSW, CAS Behavioral
Integrating Behavioral Health and Primary Health Care: Development, Maintenance, and Sustainability Cici Conti Schoenberger, LCSW, CAS Behavioral Health Provider Sunshine Community Health Center Why Integrate?
More informationKeep Your Mind and Body Healthy: Understanding Mental Health Providers, Care and Coverage
Keep Your Mind and Body Healthy: Understanding Mental Health Providers, Care and Coverage Our mental health is a vital part of our overall well-being. It affects how we think, how we feel, and how we act.
More informationPROVIDER BULLETIN No. 05-05
PROVIDER BULLETIN No. 05-05 February 15, 2005 TO: FROM: BY: RE: Speech Therapy Providers Mary Steiner, Interim Administrator, Medicaid Division Marsha Rekart, Program Specialist Medicaid coverage of speech
More informationBi-Directional Integration: What Degree of Integration is Needed for Success Linking Indiana Integration Principles to National Models
Bi-Directional Integration: What Degree of Integration is Needed for Success Linking Indiana Integration Principles to National Models What Degree of Success is Needed from the Affordable Care Act Perspective?
More informationIntensive Outpatient Psychotherapy - Adult
Intensive Outpatient Psychotherapy - Adult Definition Intensive Outpatient Psychotherapy services provide group based, non-residential, intensive, structured interventions consisting primarily of counseling
More informationThe Impact of Healthcare Reform on Pharmacy Practice. Disclosure
The Impact of Healthcare Reform on Pharmacy Practice Thomas Buckley, MPH, RPh Assistant Clinical Professor University of Connecticut School of Pharmacy Disclosure Thomas Buckley has nothing to disclose
More informationNational Quality Management
National Quality Management National Approval Date: Effective Date: 02/24/2015 Subject Practitioner and Provider Availability: Network Composition and Contracting Plan Originating Dept. National Quality
More informationMaryland Data as of July 2003. Mental Health and Substance Abuse Services in Medicaid and SCHIP in Maryland
Mental Health and Substance Abuse Services in Medicaid and SCHIP in Maryland As of July 2003, 638,662 people were covered under Maryland's Medicaid/SCHIP programs. There were 525,080 enrolled in the Medicaid
More informationInnerview Reimbursement in the Physician Office Setting * 2014
OVERVIEW This Guide is intended to assist with the process of billing and coding for Innerview, a Mental Health Clinical Decision Support System used in the primary care setting. Billing, coding and payment
More informationExamples of States Billing Codes for Mental Health Services, Publicly Funded
Examples of States Billing Codes for Mental Health Services, Publicly Funded Written by Shelagh Smith, MPH, CHES, SAMHSA s Center for Mental Health Services Complied by Eileen Charneco, SAMHSA Intern December
More informationResident Rotation: Collaborative Care Consultation Psychiatry
Resident Rotation: Collaborative Care Consultation Psychiatry Anna Ratzliff, MD, PhD James Basinski, MD With contributions from: Jurgen Unutzer, MD, MPH, MA Jennifer Sexton, MD, Catherine Howe, MD, PhD
More informationHow To Write A Code Of Conduct
Disclosures Behavioral Health Coding, Contracting and Billing, Part 1 Presented by Mimi Reed, BHSA, CPC A, MCP, MTA, Consultant, SCHA MI Mimi Reed, BHSA, CPC A, MCP, MTA, Consultant, SCHA MI Amy Valimont,
More informationCompensation and Claims Processing
Compensation and Claims Processing Compensation The network rate for eligible outpatient visits is reimbursed to you at the lesser of (1) your customary charge, less any applicable co-payments, coinsurance
More informationOutpatient Behavioral Health Original Effective Date: January 1, 2005 Services Provided by Revised Date: January 1, 2012 Direct-Enrolled Providers
Services Provided by Revised Date: January 1, 2012 Direct-Enrolled Providers Table of Contents 1.0 Description of the Procedure, Product, or Service... 1 2.0 Eligible Recipients... 1 2.1 General Provisions...
More informationUW Medicine Integrated Mental Health Care. Laura Collins MSW, Darcy Jaffe ARNP Jürgen Unützer, MD, MPH, MA
UW Medicine Integrated Mental Health Care Laura Collins MSW, Darcy Jaffe ARNP Jürgen Unützer, MD, MPH, MA Why Behavioral Health Care in Primary Care? 1. Access to care: Serve patients where they are 2.
More informationCMS Innovation Center Improving Care for Complex Patients
CMS Innovation Center Improving Care for Complex Patients ECRI Institute Dr. Patrick Conway, M.D., MSc CMS Chief Medical Officer and Deputy Administrator for Innovation and Quality Director, Center for
More informationAmbulatory Patient Groups (APG) Policy and Medicaid Billing Guidance OASAS Certified Outpatient Chemical Dependence Programs
Ambulatory Patient Groups (APG) Policy and Medicaid Billing Guidance OASAS Certified Outpatient Chemical Dependence Programs www.oasas.ny.gov TABLE OF CONTENTS SECTION: PAGE 1. Background and Introduction
More informationBilling and Claim Billing and Claim Submission Boot Camp Submission Boot Camp Beverly Remm Beverly Remm
Billing and Claim Submission Boot Camp Presented by: Beverly Remm Orion Healthcare Technology Billing and Claim Submission Boot Camp Presented by: Beverly Remm Orion Healthcare Technology The presentation
More informationMedicaid Services for Substance Abuse
Medicaid Services for Substance Abuse Community Behavioral Health Services Coverage and Limitations Handbook 2007 FADAA Annual Conference-Orlando Making Medicaid Work for Substance Abuse Agenda Overview
More informationTN No: 09-024 Supersedes Approval Date:01-27-10 Effective Date: 10/01/09 TN No: 08-011
Page 15a.2 (iii) Community Support - (adults) (CS) North Carolina is revising the State Plan to facilitate phase out of the Community Support - Adults service, which will end effective July 1, 2010. Beginning
More informationother caregivers. A beneficiary may receive one diagnostic assessment per year without any additional authorization.
4.b.(8) Diagnostic, Screening, Treatment, Preventive and Rehabilitative Services (continued) Attachment 3.1-A.1 Page 7c.2 (a) Psychotherapy Services: For the complete description of the service providers,
More informationPassport Advantage Provider Manual Section 10.0 Care Management Table of Contents
Passport Advantage Provider Manual Section 10.0 Care Management Table of Contents 10.1 Model of Care 10.2 Medication Therapy Management 10.3 Care Coordination 10.4 Complex Case Management 10.0 Care Management
More information2014 Model of Care Training SHP_2014838A
2014 Model of Care Training SHP_2014838A 1 Model of Care Training This course is offered to meet the CMS regulatory requirements for Model of Care Training for our Special Needs Plans. It also ensures
More informationLouisiana Medicaid School-Based Health Center Presentation December 2011
Louisiana Medicaid School-Based Health Center Presentation December 2011 1 Services Available Professional Services, think of a SBHC as a physician clinic dropped into the school setting. KIDMED Services,
More informationDEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services. Mental Health Services
DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services Mental Health Services ICN 903195 September 2013 This booklet was current at the time it was published or uploaded onto
More informationPartial Hospitalization - MH - Adult (Managed Medicaid only Service)
Partial Hospitalization - MH - Adult (Managed Medicaid only Service) Definition Partial hospitalization is a nonresidential treatment program that is hospital-based. The program provides diagnostic and
More informationDEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services. Mental Health Services
DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services Mental Health Services ICN 903195 January 2015 This booklet was current at the time it was published or uploaded onto the
More informationTN No. 07-004 Supersedes Approval Date: 09-24-09 Effective Date: 07-01-09 TN No. 01-006
Page 6c 440.130(d) The covered Community Mental Health Rehabilitative Services will be available to all Medicaid eligibles with mental illness and substance abuse disorders and who are medically determined
More informationKansas Data as of July 2003. Mental Health and Substance Abuse Services in Medicaid and SCHIP in Kansas
Mental Health and Substance Abuse Services in Medicaid and SCHIP in Kansas As of July 2003, 262,791 people were covered under Kansas's Medicaid and SCHIP programs. There were 233,481 enrolled in the Medicaid
More informationMental and Behavioral Health Needs Assessment
Mental and Behavioral Health Needs Assessment ADMINISTRATORS AND PRACTITIONERS SURVEY Prepared for: The Lincy Institute University of Nevada Las Vegas January 16, 2014 2 Executive Summary Mental and Behavioral
More informationTo precertify inpatient admissions or transitional care services, call 1-866-688-3400 and select option #1.
Security Health Plan provides coverage of various mental health/aoda (alcohol and other drug abuse) benefits to individual and employer group members. These benefits are managed by Security Health Plan.
More informationMental Health and Substance Abuse Services Under BadgerCare Plus
Update January 2008 No. 2008-05 BadgerCare Plus Information for Providers To: Advanced Practice Nurse Prescribers with Psychiatric Specialty, AODA Counselors, Community Support Programs, Comprehensive
More informationOUTPATIENT SUBSTANCE USE DISORDER SERVICES FEE-FOR-SERVICE
OUTPATIENT SUBSTANCE USE DISORDER SERVICES FEE-FOR-SERVICE Brief Coverage Statement Outpatient Substance Use Disorder (SUD) Fee-For-Service (FFS) Treatment Services are available for the treatment of substance
More informationTHE BASICS OF RHC BILLING. Thursday, April 28, 2011 Presented by: Health Services Associates, Inc.
THE BASICS OF RHC BILLING Thursday, April 28, 2011 Presented by: Health Services Associates, Inc. TABLE OF CONTENTS Commercial and Self Pay billing Define RHC Medicaid Specified Medicare RHC billing guidelines
More informationOhio Mental Health Parity Law - Frequently Asked Questions
Ohio Department of Insurance Mental Health Parity - Frequently Asked Questions The main provisions of the Ohio Mental Health Parity law can be found in sections 1751.01, 3923.28, 3923.281 and 3923.282
More informationSTATE OF NEBRASKA STATUTES RELATING TO NEBRASKA TELEHEALTH ACT
2014 STATE OF NEBRASKA STATUTES RELATING TO NEBRASKA TELEHEALTH ACT Department of Health and Human Services Division of Public Health Licensure Unit 301 Centennial Mall South, Third Floor PO Box 94986
More informationSocial Work Practice in Primary Care: A Natural Collaboration
Social Work Practice in Primary Care: A Natural Collaboration Presented by: Center for Social Work in Healthcare University of Oklahoma http://www.youtube.com/watch?v=l-gqlqv9f4o Examine the fit between
More informationNo. 96. An act relating to naturopathic physicians. (S.209) It is hereby enacted by the General Assembly of the State of Vermont:
No. 96. An act relating to naturopathic physicians. (S.209) It is hereby enacted by the General Assembly of the State of Vermont: Sec. 1. 8 V.S.A. 4088d(a) is amended to read: (a) A health insurance plan
More informationOutpatient Behavioral Health
Outpatient Behavioral Health 29 Chapter 29 29.1 Enrollment..................................................................... 29-2 29.1.1 Provisionally Licensed Psychologist (PLP)..................................
More informationPalliative Care Billing, Coding and Reimbursement
Palliative Care Billing, Coding and Reimbursement Anne Monroe, MHA Physician Practice Manager Hospice of the Bluegrass and Palliative Care Center of the Bluegrass Kentucky 1 Objectives Review coding and
More informationBehavioral Health Services 14.0
Behavioral Health Services 14.0 Kaiser Permanente s Behavioral Health Services operates within the multi-specialty Mid- Atlantic Permanente Medical Group (MAPMG). It is a regional service committed to
More informationPsychotherapy Professional Services
Status Active Reimbursement Policy Section: Behavioral Health Section Policy Number: RP - Behavioral Health - 001 Psychotherapy Professional Services Effective Date: June 1, 2015 Psychotherapy Professional
More informationAll payment rates and their effective dates shall be reflected in the Division's website at www.med-quest.us.
ATTACHMENT 4.19-B State: HAWAII NONINSTITUTIONAL ITEMS AND SERVICES: The State assures that the reimbursement to public and private providers of Medicaid services, products or items are the same and does
More informationcaresy caresync Chronic Care Management
caresy Chronic Care Management THE PROBLEM Chronic diseases and conditions, including heart disease, diabetes, COPD and obesity, are among the most common, expensive, and preventable health problems in
More informationSubacute Inpatient MH - Adult
Subacute Inpatient MH - Adult Definition Subacute Inpatient hospital psychiatric services are medically necessary short-term psychiatric services provided to a client with a primary psychiatric diagnosis
More informationUPDATED NOVEMBER 2015. Providing and Billing Medicare for Chronic Care Management
UPDATED NOVEMBER 2015 Providing and Billing Medicare for Chronic Care Management Research studies have demonstrated time and again that care management reduces total costs of care for chronic disease patients
More informationFrom: Odonnell, Mark [mailto:mark.odonnell@dhhs.nc.gov] Sent: Monday, November 24, 2014 3:44 PM To: 'John Shuford' Subject: RE: First Commitment
LICENSED PROFESSIONAL COUNSELORS AND LICENSED MARRIAGE AND FAMILY THERAPISTS SHOULD BE INCLUDED AS PROVIDERS WHO CAN CONDUCT FIRST EVALUATIONS FOR INVOLUNTARY COMMITMENT In 2011, the North Carolina General
More informationOther diagnostic, screening, preventive, and rehabilitative services, i.e., other. than those provided elsewhere in the plan.
State Ut Ohio Attachment 3.1 -A Item 13 -d 1- Page 1 of 28 13. Other diagnostic, screening, preventive, and rehabilitative services, i.e., other 1. Rehabilitative services provided by community mental
More informationNorth Carolina Medicaid Special Bulletin
North Carolina Medicaid Special Bulletin An Information Service of the Division of Medical Assistance Visit DMA on the web at http://www.ncdhhs.gov/dma Number 1 (Revised 8/23/11) July 2011 Pregnancy Medical
More informationCrosswalk of 2012 CPT 4 codes to 2013 CPT 4 codes
The following code changes for behavioral health are effective January 1, 2013. Crosswalk of 2012 CPT 4 codes to 2013 CPT 4 codes 2012 Code (Deleted as of January 1, 2013) 90801 Psychiatric diagnostic
More informationAlcohol and Drug Rehabilitation Providers
June 2009 Provider Bulletin Number 942 Alcohol and Drug Rehabilitation Providers New Modifier and s for Substance Abuse Services Effective with dates of service on and after July 1, 2009, eligible substance
More informationChanges for Master s-level Psychotherapists
Update December 2010 No. 2010-114 Affected Programs: BadgerCare Plus Standard Plan, BadgerCare Plus Benchmark Plan, Medicaid To: Advanced Practice Nurse Prescribers, HealthCheck Other Services Providers,
More informationReducing Adolescent Substance Abuse Initiative (RASAI) Learning Community
Howard Zucker, Acting Commissioner Arlene González-Sánchez, M.S., L.M.S.W. Commissioner Ann Marie T. Sullivan, M.D., Commissioner Reducing Adolescent Substance Abuse Initiative (RASAI) Learning Community
More informationBilling & Reimbursement of Integrated Health Services An Introductory. Presented by: Kathleen Reynolds, LMSW, ACSW Shauna Reitmeier, MSW
Billing & Reimbursement of Integrated Health Services An Introductory Presented by: Kathleen Reynolds, LMSW, ACSW Shauna Reitmeier, MSW Overview Billing and Financing topics have been one of the top requests
More informationBilling an NP's Service Under a Physician's Provider Number
660 N Central Expressway, Ste 240 Plano, TX 75074 469-246-4500 (Local) 800-880-7900 (Toll-free) FAX: 972-233-1215 info@odellsearch.com Selection from: Billing For Nurse Practitioner Services -- Update
More informationFederally Qualified Health Centers (FQHC) Billing 1163_0212
Federally Qualified Health Centers (FQHC) Billing 1163_0212 Today s Presenter Charles Wiley- Provider Outreach and Education Representative 2 Disclaimer has produced this material as an informational reference
More informationBehavioral Mental Health Care Career Guide P199, Dr. Patton Part 3. Decisions about License & Degree Program
Behavioral Mental Health Care Career Guide P199, Dr. Patton Part 3. Decisions about License & Degree Program All licensed mental health care professionals no matter whether they are generalists or specialists
More informationDSRIP QUARTERLY REVIEW PROCESS: Project Requirement - Timeframe. Project Requirement - Unit Level Reporting
Unit Level Reporting Provider Unit Level Reporting DSRIP QUARTERLY REVIEW PROCESS: PPSs will submit a quarterly report to the Independent Assessor throughout the DSRIP program via the automated MAPP tool
More informationMental Health Centers / Prepaid Mental Health Plans
SECTION 2 Table of Contents 1. GENERAL POLICY... 3 1-1 Authority... 3 1-2 Qualified Mental Health Providers... 3 1-3 Definitions... 3 1-4 Scope of Services... 4 1-5 Provider Qualifications... 5 1-6 Evaluation
More informationAmerican Society of Addiction Medicine
American Society of Addiction Medicine Public Policy Statement on Treatment for Alcohol and Other Drug Addiction 1 I. General Definitions of Addiction Treatment Addiction Treatment is the use of any planned,
More informationCommunity Health Centers and Health Reform: Issues and Ideas for States
Community Health Centers and Health Reform: Issues and Ideas for States Ann S. Torregrossa, Esq. Deputy Director & Director of Policy Governor s Office of Health Care Reform Commonwealth of Pennsylvania
More informationThe Business of Telemedicine
The Business of Telemedicine Nancy S. Rowe Associate Director, Outreach Arizona Telemedicine Program Industry Overview Telemedicine is Huge! Success stories abound telemedicine saves lives Direct to consumer
More informationMedicare Coverage of Mental Health Services. For Those Who Counsel People With Medicare
Medicare Coverage of Mental Health Services For Those Who Counsel People With Medicare July 2015 The Statistics Mental health problems are common The latest data indicates 1 in 5 American adults experienced
More informationOutpatient and Intensive Outpatient Narrative
Los Angeles County Department of Public Health Substance Abuse Prevention and Control (SAPC) will implement an initial benefit package of Substance Use Disorder (SUD) services within the initial twelve
More informationMental Health Standards of Care I. DEFINITION OF SERVICES
S OF CARE Oakland Transitional Grant Area Care and Treatment Services M ARCH 2007 Office of AIDS Administration 1000 Broadway, Suite 310 Oakland, CA 94607 Tel: (510) 268-7630 Fax: (510) 268-7631 AREAS
More informationHow To Manage Health Care Needs
HEALTH MANAGEMENT CUP recognizes the importance of promoting effective health management and preventive care for conditions that are relevant to our populations, thereby improving health care outcomes.
More informationFrequently Asked Questions on the Medicare FQHC PPS 1
Frequently Asked Questions on the Medicare FQHC PPS 1 (Rev. 12-1-15) Topics FQHC PPS Rate and GAFs New Patient, IPPE, and AWV Adjustments Per-diem Payment Exceptions FQHC PPS Payment Codes Preventive Services
More informationHow Health Reform Will Help Children with Mental Health Needs
How Health Reform Will Help Children with Mental Health Needs The new health care reform law, called the Affordable Care Act (or ACA), will give children who have mental health needs better access to the
More informationSection 8 Behavioral Health Services
Section 8 Behavioral Health Services Superior subcontracts with Cenpatico Behavioral Health Services, Inc. to manage behavioral health services (mental health and substance abuse) for Superior Members.
More information