Financing integrated Healthcare in California
|
|
|
- Lester Hood
- 8 years ago
- Views:
Transcription
1 Financing integrated Healthcare in California as of October 12, 2012 E & M Codes CPT Code ew Pt Est. Pt Diagnostic Code May be used only with physical Federally Qualified Health Centers (FQHC) Medicare State Medicaid Paid? Credentials Paid? Code Credentials Comments Y 01* MD, PA, P *See ote A MD, PA, AP Y 01 MD, PA, P Health and Behavior (HABI) Assessment Reassessment Individual Int Group Int Family + Patient Family w/o Pt Services are secondary to a physical on- physician mental practitioners only at this time; excludes CSW Y 01 MD, PA, P, Social Y 01 MD, PA, P, Social Y 01 MD, PA, P, Social Y 01 MD, PA, P, Social o Telemedicine Assess/ Psych.Eval - Physician - urse Practitioner - Physician Assistant - urse Specialist - psychologist* - social worker* *Cannot bill for psychotherapy services that include medical evaluation and management services under Medicare. May Y 01 MD, PA, P, Social Y 01 MD, PA, P, Social Med Mgmt Y 01 MD, PA, P, Use GT modifier with all tele procedure codes MD, PA, P only.
2 ew Pt not bill or receive payment for: and Est. Pt. Social Y 01 MD, PA, P, Social o 1 Y 01 MD, PA, P, Social o Y 01 MD, PA, P, Social - limited intermediate F- U Inpt - Complex Initial 30 min Initial 50 min Initial 70 min Facility Fee Y Q3014 MD, PA, P, Social Substance Abuse Codes ,90853, Physicians and non- physicians such as clinical social worker, & clinical psychologists licensed by the state AOD Assess BH Screening BH Counseling AOD Group IOP Services o Y 01 MD, PA, P, Social Y 01 MD, PA, P, Social 90813, MD, PA, P only Exclude Mental Health Used with BH Diagnosis Codes 90847, 90853, 90857,90772, 90862,90865, 90887, Physicians and non- physicians, such as clinical social workers & clinical psychologists licensed by the state Y 01 MD, PA, P, Social Y 01 MD, PA, P, Social 90813, MD, PA, P only Exclude 90857, 90772, 90865, Medicare Manual Update, Publication notes that CPT has been discontinued effective 1/1/10. These codes are to be replaced by CPT Likewise, CPT has been replaced by
3 BH Coun&Ther MH Assess Crisis Stab. o 2 Two Services in One Day Billable at the FQHC? - See ote B for exception MD only MD, only. o Case Mgmt 2 o separate billing code for crisis stabilization services, however, Medicare does permit a psychiatrist to bill for extended appointments under other CPT codes.
4 E & M Codes CPT Code ew Pt Est. Pt Diagnostic Code Used only with physical Community Mental Health Centers (CMHC) Medicare State Medicaid Paid? Credentials Paid? Code Credentials Comments Health and Behavior (HABI) Assessment Reassessment Individual Int Group Int Family + Patient Family w/o Pt Services are secondary to a physical o o o o o o on- physician mental practitioners only at this time; excludes CSW Telemedicine Assess/ Psych.Eval - Physician - urse Practitioner - Physician Assistant - urse Specialist - psychologist* - social worker* Y CPT Psychiatrist, * Med Mgmt ew Pt *Cannot bill for psychotherapy services that include medical evaluation and management services under Medicare. May not bill or receive payment for: and Y Y Y CPT CPT CPT Psychiatrist, Psychiatrist, Psychiatrist, Est. Pt o ote: When a CMHC Y CPT Psychiatrist, serves as an originating o site, the originating site Y CPT Psychiatrist, facility fee does not count toward the - limited number of services used to determine payment intermediate for partial hospitalization services. F- U Inpt - Complex Initial 30 min Initial 50 min Initial 70 min Facility Fee Y Q3014 Psychiatrist, * See ote C for credential description. Use GT modifier with all tele procedure codes Substa nce Abuse Codes Physicians and non- physicians such as clinical social worker, & clinical psychologists Y CPT Psychiatrist, 90813, Psychiatrist only
5 90847,90853, AOD Assess BH Screening BH Counseling AOD Group IOP Services o licensed by the state Y CPT Psychiatrist, Exclude 90847, Mental Health Physicians, CSW s, clinical nurse practitioners, clinical nurse specialists, and psychologists licensed by States Y CPT Psychiatrist, Y CPT Psychiatrist, Y CPT Psychiatrist, 90845,90847, Y CPT Psychiatrist, 90853,90857, 90865, y Y CPT Psychiatrist Crisis Services CPT 90813, 90815, 90817, Psychiatrist only 90822, Psychiatrist only , Psychiatrist only. Exclude 90845, 90847, 90857, Case Mgmt Sources: California Department of Health Care Services, Medi-Cal,Rural Health Clinics & Federally Qualified Health Centers. California Department of Health Care Services, Medi-Cal, Rural Health Clinics & Federally Qualified Health Centers: Billing Codes California Department of Health Care Services, Medi-Cal, Medical Services, Telemedicine California Department of Health Care Services, Medi-Cal Rates as of 09/15/ cal.ca.gov/pubsdoco/rates/rateshome.asp California Department of Health Care Services, Medi-Cal, Specialty Mental Health Services
6 otes: A. All inclusive encounter code may vary if client is enrolled in a Medi-Cal managed care plan. See California Department of Health Care Services, Medi-Cal, Rural Health Clinics & Federally Qualified Health Centers: Billing Codes B. Qualifying Visit Definition, Page 5, California Department of Health Care Services, Medi- Cal,Rural Health Clinics & Federally Qualified Health Centers. C. Licensed Providers, Page 3, California Department of Health Care Services, Medi-Cal, Specialty Mental Health Services.
Financing 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
Behavioral 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
TELEMEDICINE POLICY. Page
TELEMEDICINE POLICY REIMBURSEMENT POLICY Policy Number: ADMINISTRATIVE 4.23 T0 Effective Date: July, 205 Table of Contents APPLICABLE LINES OF BUSINESS/PRODUCTS.. APPLICATION... OVERVIEW... REIMBURSEMENT
TELEMEDICINE POLICY. Page
TELEMEDICINE POLICY REIMBURSEMENT POLICY Policy Number: ADMINISTRATIVE 4.8 T0 Effective Date: May, 203 Table of Contents APPLICABLE LINES OF BUSINESS/PRODUCTS.. APPLICATION... OVERVIEW... REIMBURSEMENT
Billing & 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
Telemedicine Policy. Approved By 1/27/2014
REIMBURSEMENT POLICY Policy Number 2015R0046F Annual Approval Date Telemedicine Policy 1/27/2014 Approved By National Reimbursement Forum United HealthCare Community & State Payment Policy Committee IMPORTANT
Collaborative Care Tips for Sustainability. Virna Little, PsyD, LCSW r, SAP The Institute for Family Health NYS Collaborative Care Initiative
Collaborative Care Tips for Sustainability Virna Little, PsyD, LCSW r, SAP The Institute for Family Health NYS Collaborative Care Initiative Teamwork Applies to Billing Too!!! Combine with other initiatives
The 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
Telemedicine Policy Annual Approval Date
Policy Number 2016R0046A Telemedicine Policy Annual Approval Date 4/08/2015 Approved By REIMBURSEMENT POLICY CMS-1500 Payment Policy Oversight Committee IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY You
Behavioral Health Covered Services & Authorization Guidelines Florida Managed Medical Assistance (MMA) & Child Welfare (CW)
Behavioral Health Covered Services & Authorization Guidelines Florida Managed Medical Assistance (MMA) & Child Welfare (CW) Please refer to your Agreement with Cenpatico to identify additional services
Community Mental Health Services (Provider Type 84)
Ohio Department of Mental Health and Addiction Services (ODMS) MyCare Ohio Billing Guide For members who have Molina MyCare Ohio for both and, providers will only need to bill a single claim and it will
Value of integrating telepsychiatry and primary care in the Rockies
Value of integrating telepsychiatry and primary care in the Rockies Presented by: University of Wyoming Center for Rural Health Research and Education and Access Psychiatry Solutions, LLC Rex Gantenbein
Remote Access Technologies/Telehealth Services Medicare Effective January 1, 2016
Remote Access Technologies/Telehealth Services Medicare Effective January 1, 2016 Prior Authorization Requirement Yes No Not Applicable * Not covered by Medicare but is covered by HealthPartners Freedom
Telehealth Services. Part B Provider Outreach and Education January 2016
Telehealth Services Part B Provider Outreach and Education January 2016 DISCLAIMER This information release is the property of Noridian Healthcare Solutions, LLC. It may be freely distributed in its entirety
New 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.
National 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
Assertive 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
GEORGIA MEDICAID TELEMEDICINE HANDBOOK
GEORGIA MEDICAID TELEMEDICINE HANDBOOK CONNECTING GEORGIA OVERVIEW The Department of Community Health s (DCH) Telemedicine and Telehealth policies are slated to improve and increase access and efficiency
2013 CPT Code Changes Frequently Asked Questions
Are codes for higher levels of care (e.g. H0015, H2035, and H0018) impacted at all by these CPT code changes, or will these remain the same on contracts for those services? Procedure codes H2022 and H0046
Alcohol 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
Acute Care & Outpatient Facility Services. Facility 101, 110, 114, 124, 134, 21, 51, 55, 56 Yes. Facility 905, 906 22, 52, L
Behavioral Health Covered Services & orization Guidelines Ohio Covered Families and Children (CFC), Age Blind and Disabled (ABD) and Ohio MyCare Medicare/Medicaid (MMP) Please refer to your Agreement with
D E F I N E V E L O D O. Telemedicine Reimbursement Handbook. 2012 Edition. CTEConline.org
L O D E F I N E D E V E P D O Telemedicine Reimbursement Handbook 2012 Edition CTEConline.org Telemedicine Reimbursement Handbook 2012 California Edition California Telemedicine & ehealth Center Christine
Division 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.
Federally Qualified Health Center Billing (100)
1. As a federally qualified health center (FQHC) can we bill for a license medical social worker? The core practitioner must be a licensed or certified clinical social worker (CSW) in your state. Unless
TELEMEDICINE, TELEHEALTH, AND HOME TELEMONITORING TEXAS MEDICAID SERVICES. Biennial Report to the Texas Legislature
TELEMEDICINE, TELEHEALTH, AND HOME TELEMONITORING TEXAS MEDICAID SERVICES Biennial Report to the Texas Legislature As Required by Texas Government Code 531.0216 Texas Health and Human Services Commission
Examples 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
Draft Telemedicine Provider Guidance/Manual
I. Introduction The D.C. Telehealth Reimbursement Act of 2013 directs Medicaid to cover and reimburse for healthcare services appropriately delivered through telehealth if the same services would be covered
Intensive Outpatient Psychotherapy - Adult
Intensive Outpatient Psychotherapy - Adult Definition Intensive Outpatient Psychotherapy services provide group based, non-residential, intensive, structured interventions consisting primarily of counseling
IOWA. Recent news, pending action: Pending legislation: Medicaid law and regulations: From Telemedicine for CSHCN: A State- by- State
IOWA State Recent news, pending action: Pending legislation: for CSHCN: A State- by- State Comparison of Medicaid Policies and Title V Activities (2005) prepared by Connections for Children and Youth:
CABHAs and non-cabha agencies may provide Comprehensive Clinical Assessments, Medication Management, and Outpatient Therapy.
Page 7c.1b 4.b Early and periodic screening, diagnostic and treatment services for individuals under 21 years of age, and treatment of conditions found. (continued) Critical Access Behavioral Health Agency
other 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,
Palliative 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
DEPARTMENT 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
Florida Data as of July 2003. Mental Health and Substance Abuse Services in Medicaid and SCHIP in Florida
Mental Health and Substance Abuse Services in Medicaid and SCHIP in Florida As of July 2003 2,441,266 people were covered under Florida's Medicaid and SCHIP programs. There were 2,113,820 enrolled in the
Telehealth Billing for Michigan RHCs and CAHs
Telehealth Billing for Michigan RHCs and CAHs Jonathan Neufeld, PhD Upper Midwest Telehealth Resource Center Michigan Center for Rural Health Webinar June 10, 2015 This project is/was supported by the
Maryland 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
WHAT IS TELEHEALTH? Telehealth refers to: Telemedicine (Real-time clinical services) Telecommunication (Store-and-forward services) Distance Education
03/17/15 INTRODUCTION This document is intended as a reference for those responsible for billing Telehealth services to AHCCCS Division of Fee for Service Management (DFSM). NOTE: The services described
Psychotherapy 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
Professional Criteria and Medicaid Reimbursable Outpatient Services by Professionals
Professional Criteria and Medicaid Reimbursable Outpatient Services by Professionals The purpose of this document is to clarify who can provide which outpatient services to Iowa Plan Medicaid members.
ATTENTION: ALTERNATIVE BILLING CONCEPTS (ABC) CODES FOR BEHAVIORAL HEALTH SERVICES TO END AS OF 12/31/2009
ATTENTION: ALTERNATIVE BILLING CONCEPTS (ABC) CODES FOR BEHAVIORAL HEALTH SERVICES TO END AS OF 12/31/2009 Alaska Medical Assistance will transition from use of Alternative Billing Concepts (ABC) procedure
MEDICAL POLICY: Telehealth Services
POLICY........ PG-0142 EFFECTIVE......01/01/08 LAST REVIEW... 01/12/16 MEDICAL POLICY: Telehealth Services GUIDELINES This policy does not certify benefits or authorization of benefits, which is designated
Innovative Ways to Leverage Funding for Health Care in Schools
Innovative Ways to Leverage Funding for Health Care in Schools NATIONAL ALLIANCE FOR MEDICAID IN EDUCATION (NAME) ANNUAL CONFERENCE October 10, 2013 SESSION OBJECTIVES Learn about strategies used Michigan
Driving Telehealth Adoption Through the Triple Aim. Jonathan Neufeld, PhD, HSPP Ohio SORH Annual Conference November 21, 2014
Driving Telehealth Adoption Through the Triple Aim Jonathan Neufeld, PhD, HSPP Ohio SORH Annual Conference November 21, 2014 1 Outline UMTRC and National TRC Program Aspiring to the Triple Aim Some Helpful
ILLINOIS DEPARTMENT OF HEALTHCARE & FAMILY SERVICES Federally Qualified Health Centers (FQHC) Rural Health Centers (RHC) 03-08 08-12 DEFINITION OF AN ENCOUNTER A billable encounter is defined as a face-
Managed 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
Frequently 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
CPT Coding Changes for 2013
CPT Coding Changes for 2013 Getting Prepared Presenter Ronald Burd, MD Psychiatrist, Stanford Health, Fargo, ND Chair, APA Committee on Codes, RBRVS and Reimbursements APA Representative, AMA s RBRVS Update
Informational Notice
Pat Quinn, Governor Barry S. Maram, Director 201 South Grand Avenue East Springfield, Illinois 62763-0002 Telephone: 1-877-782-5565 TTY: 1-800-526-5812 Informational Notice Date: January 12, 2010 To: Re:
Telemedicine and Telehealth Services
INDIANA HEALTH COVERAGE PROGRAMS PROVIDER REFERENCE M ODULE Telemedicine and Telehealth Services L I B R A R Y R E F E R E N C E N U M B E R : P R O M O D 0 0 0 4 8 P U B L I S H E D : F E B R U A R Y
CPT 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
HEALTH SERVICES ASSOCIATES, INC
HEALTH SERVICES ASSOCIATES, INC Ron L. Nelson, PA www.hsagroup.net 2 East Main Street Fremont, Michigan 49412 Ph: 231-924-0244 Fx: 231-924-4882 Email:nelson@hsagroup.net Understanding Billing Issues RHC
The 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
Billing and Coding Update in the Nursing Home 2015
Billing and Coding Update in the Nursing Home 2015 Charles Crecelius MD PhD FACP CMD Agenda Review of nursing home basic coding requirements Use of NPP New Transition of Care code Ancillary CPT codes,
How 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,
Billing 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
Mental Health and Substance Abuse Services in Medicaid and SCHIP in Colorado
Mental Health and Substance Abuse Services in Medicaid and SCHIP in Colorado As of July 2003, 377,123 people were covered under Colorado s Medicaid and SCHIP programs. There were 330,499 enrolled in the
OBSERVATION CARE EVALUATION AND MANAGEMENT CODES
REIMBURSEMENT POLICY OBSERVATION CARE EVALUATION AND MANAGEMENT CODES Policy Number: ADMINISTRATIVE 232.8 T0 Effective Date: April, 205 Table of Contents APPLICABLE LINES OF BUSINESS/PRODUCTS... APPLICATION...
The Health Care Transformation Glossary
The Health Care Transformation Glossary which was compiled using a variety of sources helps to educate your staff, governance and community about the new language associated with transformation. Using
THE 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
Crosswalk 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
OUTPATIENT 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
NEW 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
May 9, 2014. Hon. Mike Thompson 231 Cannon House Office Building Washington, D.C. 20515. RE: Telehealth Promotion Act of 2014. Dear Rep.
Hon. Mike Thompson 231 Cannon House Office Building Washington, D.C. 20515 RE: Telehealth Promotion Act of 2014 Dear Rep. Thompson: On behalf of the 110,600 physician and student members of the American
Mental Health & Substance Abuse Services
Mental Health & Substance Abuse Services Services Overview The Adult Behavioral Health (ABH) Department provides Mental Health and Substance Abuse services to clients who meet criteria for either Substance
FAQs 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
Medicare & 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
TN 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
Kansas 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
BEHAVIORAL MEDICINE CODING AND BILLING GUIDE DEVELOPED: FEBRUARY 2005
BEHAVIORAL MEDICINE CODING AND BILLING GUIDE DEVELOPED: FEBRUARY 2005 This is a matrix of basic coding and billing information, arranged by payer, for coding and billing guidance. It should be used in
General GAP Questions
General GAP Questions 1. What is GAP? The Governor s Access Plan, known as GAP, is a demonstration program offering a targeted benefit package for up to 20,000 Virginians who have income less than 100%
Medicare 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
Cathy Francis, PsyD, MFT St. Joseph s Behavioral Health Center
Breathing New Life into Partial Hospitalization Programs Cathy Francis, PsyD, MFT St. Joseph s Behavioral Health Center 1 Breathing New Life into Partial Hospitalization Programs Presented by: Cathy Francis,
Integrating 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?
Victoria Soltis-Jarrett, PhD, PMHCNS/NP-BC Associate Professor & Coordinator of the PMHNP Program University of North Carolina at Chapel Hill School
Victoria Soltis-Jarrett, PhD, PMHCNS/NP-BC Associate Professor & Coordinator of the PMHNP Program University of North Carolina at Chapel Hill School of Nursing History of the role: PMHNP Psychiatric Advanced
PBHCI Sustainability Checklist
What Is This? PBHCI Sustainability Checklist The Sustainability Checklist lists many of the most important elements of your clinical organization that need to change to support integration in your clinic.
Frequently 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
HOW TO SUBMIT OWCP - 1500 BILLS TO ACS
HOW TO SUBMIT OWCP - 1500 BILLS TO ACS The services performed by the following providers should be billed on the OWCP-1500 Form: Physicians (MD, DO) Radiologists Independent Laboratories Audiologists/Speech
Behavioral Health Rehabilitation Services: Brief Treatment Model
Behavioral Health Rehabilitation Services: Brief Treatment Model Presented by Allegheny HealthChoices, Inc. 444 Liberty Avenue, Pittsburgh, PA 15222 Phone: 412/325-1100 Fax 412/325-1111 April 2006 AHCI
OFFICE OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES BULLETIN
OFFICE OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES BULLETIN ISSUE DATE: May 23, 2014 EFFECTIVE DATE: May 26, 2014 NUMBER: OMHSAS-14-02 SUBJECT: Enrollment and Payment of Licensed Providers that Provide
Keys to Health Center Success June Conference. Stewart Levy President - Health Promotion Solutions
1 Keys to Health Center Success June Conference Stewart Levy President - Health Promotion Solutions 2 Agenda Introduction Definitions - Telehealth, Telemedicine, Telepresence Benefits to Healthcare System
DEPARTMENT 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
DELAWARE DISTRICT OF COLUMBIA MARYLAND. State- Specific Information Recent news, pending action:
State DELAWARE DISTRICT OF COLUMBIA MARYLAND State- Specific Information Recent news, June 27, 2012 - Delaware Medicaid program to reimburse for telemedicine- delivered services beginning July 1. Delaware
MEDICARE TEACHING PHYSICIAN QUESTIONS & ANSWERS December 2003
MEDICARE TEACHING PHYSICIAN QUESTIONS & ANSWERS December 2003 In November 2002 CMS issued revisions to the Carrier Manual Instructions, section 15016, Supervising Physicians in Teaching Settings. To help
Telemedicine Reimbursement. and Credentialing
Kim Hoffman Telehealth Coordinator OHSU Telemedicine and Credentialing Kate Kenemer Client Service Analyst University Professional Services Why is it important? Encourages use of telemedicine services
Intensive Outpatient Program (IOP) Clinical Documentation Training. February 2013
Intensive Outpatient Program (IOP) Clinical Documentation Training February 2013 Training Objectives APS Healthcare Introduction Utilization Review Process Overview of Medical Necessity Clinical Documentation
PSYCHOTHERAPY: 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
Telemedicine and Telehealth Services
Telemedicine and Telehealth Services Chapter.1 Enrollment..................................................................... -2.2 Benefits, Limitations, and Authorization Requirements...........................
Oregon Data as of July 2003. Mental Health and Substance Abuse Services in Medicaid and SCHIP in Oregon
Mental Health and Substance Abuse Services in Medicaid and SCHIP in Oregon As of July 2003, 398,874 people were covered under Oregon s Medicaid/SCHIP programs. There were 380,546 enrolled in the Medicaid
CPT and RBRVS 2013 Annual Symposium November 14-16, 2012
CPT and RBRVS 2013 Annual Symposium November 14-16, 2012 Psychotherapy Antonio E. Puente, PhD, AMA CPT Editorial Panel Member, Co-Chair, AMA Health Care Professionals Advisory Committee (HCPAC) Jeremy
Session 14. Act Now-Review of the 2015 Telemedicine Law. 2016 Minnesota e-health Summit June 7, 2016, 2:15 PM
Session 14 Act Now-Review of the 2015 Telemedicine Law 2016 Minnesota e-health Summit June 7, 2016, 2:15 PM 1 Speakers Moderator: Mark Sonneborn Presenter: Maureen Ideker RN, BSN, MBA, Great Plains Telehealth
Addiction Billing. Kimber Debelak, CMC, CMOM, CMIS Director, Recovery Pathways
Addiction Billing Kimber Debelak, CMC, CMOM, CMIS Director, Recovery Pathways Objectives Provide overview of addiction billing contrasting E&M vs. behavioral health codes Present system changes in ICD-9
Organizational and Financial Integration of Behavioral Health into Accountable Care Organizations
Organizational and Financial Integration of Behavioral Health into Accountable Care Organizations Aricca Van Citters, MS Valerie Lewis, PhD Karen Schoenherr, BA Stephen Bartels, MD, MS ACO adoption is
State Policy Report #34. Health Center Reimbursement for Behavioral Health Services in Medicaid
State Policy Report #34 Health Center Reimbursement for Behavioral Health Services in Medicaid November 2010 COPYRIGHT NOVEMBER 2010 National Association of Community Health Centers, 2010 State Policy
Procedure/ Revenue Code. Billing NPI Required. Rendering NPI Required. Service/Revenue Code Description. Yes No No
Procedure/ Revenue Code Service/Revenue Code Description Billing NPI Rendering NPI Attending/ Admitting NPI 0100 Inpatient Services Yes No Yes 0114 Room & Board - private psychiatric Yes No Yes 0124 Room
Behavioral Health Quality Standards for Providers
Behavioral Health Quality Standards for Providers TABLE OF CONTENTS I. Behavioral Health Quality Standards Access Standards A. Access Standards B. After-Hours C. Continuity and Coordination of Care 1.
Consolidated 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
medne tele Medicine: Telemedicine 1
Medicine: Telemedicine 1 The Telemedicine Act of 1996 made the practice of telemedicine a legitimate means by which an individual may receive medical from a health care provider without requiring person-to-person
CHAPTER 5 SERVICE DESCRIPTIONS. Inpatient Hospital Psychiatric Services. Service Coverage
CHAPTER 5 SERVICE DESCRIPTIONS Inpatient Hospital Psychiatric Services Service Coverage Inpatient psychiatric care involves skilled psychiatric services in a hospital setting. The care delivered includes
Telemedicine Policy. Dr. Melinda Rowe Assistant Medical Director November 17, 2015
Telemedicine Policy Dr. Melinda Rowe Assistant Medical Director November 17, 2015 Alabama Medicaid Telemedicine History Began coverage for Psychiatry and Dermatology specialists in 2010 50 mile limitation
BEACON HEALTH STRATEGIES, LLC TELEHEALTH PROGRAM SPECIFICATION
BEACON HEALTH STRATEGIES, LLC TELEHEALTH PROGRAM SPECIFICATION Providers contracted for the telehealth service will be expected to comply with all requirements of the performance specifications. Additionally,