Author Topic: Mental Health Billing  (Read 4113 times)

margemib

  • Full Member
  • ***
  • Posts: 210
Re: Mental Health Billing
« Reply #15 on: February 22, 2009, 02:10:49 PM »
Thanks Alice,
what do you think about the child and youth services.
can you bill for them, some are private practices I see?
I'm not sure but it comes up alot when I type in counseling.
margemib
Margie Finlay CMRS

Pay_My_Claims

  • Guest
Re: Mental Health Billing
« Reply #16 on: February 22, 2009, 05:16:27 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

Here is a great link for Mental Health billing.........Medicare

http://www.medicarenhic.com/providers/pubs/Mental_Health1208.pdf

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4710
    • Solutions Medical Billing
Re: Mental Health Billing
« Reply #17 on: February 22, 2009, 07:32:38 PM »
Not using the modifier shouldn't result in a higher reimbursement.  (Of course I must tell you I am an extremely optimistic person who lives in a very happy world.  :) )  If they require the modifier they should deny the claim without it.  The reimbursement should be based on the rendering provider's NPI number and how Medicare has them credentialed.  I certainly would hope it would work that way or else it could get quite messy.  I know the fee schedule for the psychologist is higher than a social worker but I hope there is more to the system than relying on the modifier. 

Can you imagine the mess if they paid higher, then went back to request the overpayment?  Ughhh. 

Anyway, since I don't bill in any regions that require the AJ modifier I am not sure.  But I appreciate the link, it really has some great info!

Michele
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

Pay_My_Claims

  • Guest
Re: Mental Health Billing
« Reply #18 on: February 22, 2009, 08:28:40 PM »
You are welcome.....but I would re-read page 24. They don't reimburse by the NPI, they use the modifier for reimbursement. A LCSW and a Clinical psychologist use the same cpt, the modifier determines how its reimbursed. the NPI is going to reflect the group. Within that group you can be seen by either or. I'm not proclaiming to be the expert, I am just cautious when it comes to Medicare/Medicaid/Tricare billing. I wouldn't just continue to bill that way, just because its getting it paid until I contacted Medicare to determine if the modifier was required. I also don't think it varies from one state to another since Medicare is a federally funded program. The only difference is your FI.

Good blessings.

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4710
    • Solutions Medical Billing
Re: Mental Health Billing
« Reply #19 on: February 23, 2009, 09:23:02 AM »
Thanks.  Currently our local Medicare switched carriers on 9/1/08 and it is such a mess Congressman Arcuri is involved.  But I will reread that and look into it further.

Michele
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

Alice Scott

  • Global Moderator
  • Full Member
  • *****
  • Posts: 209
    • Solutions Medical Billing
Re: Mental Health Billing
« Reply #20 on: February 23, 2009, 02:27:30 PM »
They could be either private and interested or government sponsored.  I don't think you could tell without calling.
Alice
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com