Wiki Psych NP Billing

[jillmoore1355]

We are a small non profit currently made up of therapists however we are looking at bringing on a psychiatric NP but are unsure of what codes to use as we do not have a certified biller on staff. Can anyone help with some basic codes and explain how E/M codes and add on codes would work. The reimbursement rates from insurance for 99214 and 99215 do not look very appealing. 90792 is fine, but we are aware can only be used once.
What codes do most practices use for billing for these services. Thanks so much in advance!

 

[jkyles]

Hi there, this is a question that would require an extremely long and detailed answer. I'm not going to attempt it here.
Some suggestions:
1. Start with your state's scope of practice to determine what services the NP can perform.
2. Figure out which of those services you want the NP to perform in your organization.
3. Review the current CPT Manual to determine which codes the NP might bill.
4. Review the basic guidelines to report those services. You also need to understand rules and policies of your various payers.
5. Take advantage of the articles that AAPC has published on how to use the CPT manual and the codes you'll be reporting, including the latest information on E/M codes.

Finally, I'd just add that you're always going to bill the code that reflects the work performed, so reimbursement may not always be as high as you'd like.

Good luck!

 

[jillmoore1355]

Hi there, this is a question that would require an extremely long and detailed answer. I'm not going to attempt it here.
Some suggestions:
1. Start with your state's scope of practice to determine what services the NP can perform.
2. Figure out which of those services you want the NP to perform in your organization.
3. Review the current CPT Manual to determine which codes the NP might bill.
4. Review the basic guidelines to report those services. You also need to understand rules and policies of your various payers.
5. Take advantage of the articles that AAPC has published on how to use the CPT manual and the codes you'll be reporting, including the latest information on E/M codes.

Finally, I'd just add that you're always going to bill the code that reflects the work performed, so reimbursement may not always be as high as you'd like.

Good luck!

Thank you....I figured it was too loaded of a question.....would probably do us good to hire a billing consultant for this. . Thanks for taking the time to answer!

 

[jkyles]

No worries, it's a tricky area and it is easy to make mistakes. Plus, there's so much auditing these days. Whatever you spend on an expert will definitely be worth it.