Author Topic: Medicare...billing w/supervision  (Read 1647 times)

mn7585

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Medicare...billing w/supervision
« on: November 17, 2015, 02:41:02 PM »
Took this mental health billing position over almost a year an half ago and now I'm slowly discovering small things that are out of place.

We have a psychologist on staff that we bill Medicare for due to the fact that we have LPC-MH & LMFT in this office. Today it came to my attention that the only way to bill using the supervisors NPI is we have to have each LPC-MH and LMFT enrolled with Medicare...Is this correct? It seems every time I contact Medicare I get a different answer.

Would someone be able to help me with this? Thank you!
« Last Edit: November 17, 2015, 03:04:18 PM by mn7585 »

rdmoore2003

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Re: Medicare...billing w/supervision
« Reply #1 on: November 17, 2015, 04:13:23 PM »
What state are you in?  Our Medicare does not recognized LPC's here and will not enroll them.  My Medical Psychologist does the supervision with LPC's in our office.
Regina

mn7585

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Re: Medicare...billing w/supervision
« Reply #2 on: November 17, 2015, 04:35:26 PM »
South Dakota

mn7585

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Re: Medicare...billing w/supervision
« Reply #3 on: November 17, 2015, 04:42:21 PM »
By the way our psychologist is a clinical psychologist...if that helps any

tinaraynor

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Re: Medicare...billing w/supervision
« Reply #4 on: November 17, 2015, 04:53:43 PM »
I don't believe you can enroll LPCs or LMFT with Medicare. You could bill their services "incident to" the clinical psychologist (provided they are licensed and credentialed in your state to provide the services and the psychologist is a Medicare provider). But if you are not familiar with "incident to" requirements of CMS, please check those out first. Here's a brief paragraph from CMS:

“Incident to” services are also relevant to services supervised by certain non-physician practitioners such as physician assistants, nurse practitioners, clinical nurse specialists, nurse midwives, or clinical psychologists. These services are subject to the same requirements as physician-supervised services. Remember that “incident services” supervised by non-physician practitioners are reimbursed at 85 percent of the physician fee schedule. For clarity's sake, this
article will refer to “physician” services as inclusive of non-physician practitioners. To qualify as “incident to,” services must be part of your patent's normal course of treatment, during which a physician personally performed an initial service and remains actively involved in the course of treatment. You do not have to be physically present in the patent's treatment room while these services are provided, but you must provide direct supervision, that is, you must be present in the office suite to render assistance, if necessary. The patient record should document the essential requirements for incident to service.

The outpatient mental health clinic I worked for billed incident to psychiatrists, a clinical psychologist and psychiatric nurse practitioners. These professionals always provided the INITIAL service, made the diagnosis and ordered the course of treatment which the therapists would then provide following the "incident to" requirements.

Hope this info is beneficial.

mn7585

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Re: Medicare...billing w/supervision
« Reply #5 on: November 18, 2015, 12:27:27 PM »
Great thank you Tina that makes sense!