Wiki NP billing question

[annapadgett]

I have a clinic that is owned by LCSW. The clinic wants to bring on a NP in January for medication management. I'm assuming the codes would be E/M codes. Owner asked me for the reimbursement for 1.5 hour of consulting plus medication management.....I'm at a loss.

They also want to hire a yoga therapist to incorporate yoga into individual therapy for trauma. Wouldn't this be cash?

TIA!

 

[csperoni]

What exact service is the NP providing? Is that 1.5 hour of "consulting" (which could have 100 different meanings depending on the context) plus medical management, mean the patient has a 90 minute E/M face to face visit during which the NP will manage medications? Or a 90 minute psycho therapy session? Or spending 90 minutes along with the LCSW?
No direct experience with this, but I have never heard of yoga being covered under insurance.

 

[TThivierge]

Hi Anna P
I too have never heard getting reimbursed for yoga. But it is a interesting concept. I d collect cash too for yoga and file their claims as a nicety. At my hospital they have a clinic for the elderly with chronic diseases . They offer exercise class but the patients arrive and the teacher is leading exercise as phys therapist. I believe they get grant funds or might bill the patient insurance . I know Medicare and Medica DO NOT cover such sessions. Some of the instructors do Zoom classes with the incapacitate pts. who can t get to the class/clinic. But I Goggled thus got this info from United HC ..."To qualify for the $200 reimbursement, you must complete at least 50 classes within a six-month period. Qualifying classes include yoga, aerobics, and more. info from United Healthcare". There are dx and CPT codes to use such as Z71.82 Exer Counseling put last on claim , Dx E66.3 with BMI % dx code of Z68, and other reasons such as Cardiac conditions I25, HTN I11, , DM E11 , Muscle problems such as Osteoarthritis M17, Muscle Stiffness M25.661 of R knee as examples. Dx R28 Unspecified Muscle twitching or other problems.
Id suggest the NP just do not only med mgmnt but session for medical care. Bill CPT 99202 to 99214 with proper documentation linked with their chronic conditions need meds for. The med record format be same list nature of complaint, HPI, ROS listings and section for listing medications, PFSH, .Ensure NP gives dx and assessment codes. The send pt. to lab or xray if required & ordered by the NP. You do know the LCSW and NP can do telehealth phone calls or video now. Right?

I hope this data helps you

Lady T