Author Topic: Mental Health Billing  (Read 4111 times)

bethcanare

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Mental Health Billing
« on: January 20, 2009, 02:19:31 PM »
I recently purchased the Mental Health Big Book.  I noticed on the CMS case study samples most of the claims don't have modifiers.  Is that common in mental health billing?  Do you also bill Worker's Comp in mental health?

Thank you very much in advance for helping a newbie like me.   :)

Beth

Michele

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Re: Mental Health Billing
« Reply #1 on: January 20, 2009, 05:46:28 PM »
Mental health claims hardly ever require the use of a modifier. 

There are some times that workers comp may be billed for a mental health claim but it is not common.  We had a situation once where an employee of a grocery store was robbed at knife point.  They weren't injured physically but they did need counseling to be able to return to work.  The claim was billed out to the comp carrier on the CMS form as it would be billed to the patient's regular insurance, just with the comp info.

Michele
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bethcanare

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Re: Mental Health Billing
« Reply #2 on: January 20, 2009, 06:51:58 PM »
Thank you, Michele.  That will help me a lot.

Beth C

billingfromhome428

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Re: Mental Health Billing
« Reply #3 on: February 18, 2009, 09:10:29 AM »
One case that I know of where a modifier is required for Mental Health and that is when you are billing Medicare for a LCSW.  You must submit a AJ modifier.  I have been billing for a LCSW for over 4 years and that is the only one I have ever used. :)

Michele

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Re: Mental Health Billing
« Reply #4 on: February 18, 2009, 12:38:06 PM »
We bill for 17 LCSW's and I have not heard of that before!  Interesting.  Since our claims are being paid I'm going to leave it as is.  Just curious, where are you in the country.  I'm thinking it must be a carrier specific requirement.

Michele
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Pay_My_Claims

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Re: Mental Health Billing
« Reply #5 on: February 18, 2009, 09:58:03 PM »
Its that way for NC...where are you Michele?


Michele

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Re: Mental Health Billing
« Reply #7 on: February 19, 2009, 08:43:44 AM »
Upstate (Central) NY.  But we bill for LCSW's all over NY State, Florida, and PA.

Thanks for the links, I will check them out.

Michele
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Pay_My_Claims

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Re: Mental Health Billing
« Reply #8 on: February 19, 2009, 10:22:17 AM »
You are more than welcome.

billingfromhome428

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Re: Mental Health Billing
« Reply #9 on: February 20, 2009, 08:16:00 AM »
We bill for 17 LCSW's and I have not heard of that before!  Interesting.  Since our claims are being paid I'm going to leave it as is.  Just curious, where are you in the country.  I'm thinking it must be a carrier specific requirement.

Michele


Michele,

I am in Indiana.

Michele

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Re: Mental Health Billing
« Reply #10 on: February 21, 2009, 09:53:12 PM »
Well thanks for sharing the info.  It's always good to know what is done in other areas.

Michele
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Pay_My_Claims

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Re: Mental Health Billing
« Reply #11 on: February 21, 2009, 11:16:02 PM »
Michele, I have been researching some information, and it seems that the fee schedule for a LCSW and a clinical psychologist are different (never done mental health billing). Leaving off the modifer, your claims could still get paid (obviously) but be reimbursed at a higher rate than allowed.

Pay_My_Claims

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Re: Mental Health Billing
« Reply #12 on: February 22, 2009, 08:29:38 AM »

margemib

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Re: Mental Health Billing
« Reply #13 on: February 22, 2009, 11:43:27 AM »
michele,
I am trying to take your advice and target mental health at first, I read that in one of your posts.
When I try to look this up in the yellow pages I come up with very few.
Is child and youth service fall into the same area can you bill for this.
Please give me some tips on looking this up in the yellow pages. what are the key words?
margemib
Margie Finlay CMRS

Alice Scott

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Re: Mental Health Billing
« Reply #14 on: February 22, 2009, 01:44:16 PM »
Hi,
There are many listings you can look under.  Some will refer you to others.  Try counselors, marriage counseling, psychiatrists, psychologists and see what you find.
Alice
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