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Mental Health modifers

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ukfiona:
With the new BCBS contracts in Florida, the reimbursement rate for 90834 and 90837 are now the same at $70. I have been asked to look into using modifier codes to be more specific and possibly get paid more. Any ideas?

PMRNC:

--- Quote ---With the new BCBS contracts in Florida, the reimbursement rate for 90834 and 90837 are now the same at $70. I have been asked to look into using modifier codes to be more specific and possibly get paid more. Any ideas?
--- End quote ---

Billing a modifier to boost reimbursement higher wouldn't be appropriate at all as the rate isn't going to increase for these types of service with any modifier.  Carriers also usually will not pay more than one therapy (group or individual) per day.

Michele:
Ditto to what Linda said.  But I find it odd they pay the same amount for the 90834 and the 90837.  I would double check to see if that is correct.

Christy:
Empire BCBS in New York pays the same for 90834 and 90837.   $80.

Michele:

--- Quote from: Christy on September 25, 2017, 06:22:57 PM ---Empire BCBS in New York pays the same for 90834 and 90837.   $80.

--- End quote ---

Really?  Wow.  We bill a lot of mental health and I don't believe we've ever come across that.  We do run across plans that don't allow the 90837 but not with the same allowable rates. 

Ya learn something new every day!

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