Author Topic: Behavioral Health Billing  (Read 144 times)

PMRM

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Behavioral Health Billing
« on: August 29, 2017, 08:41:16 PM »
Behavioral health billing is a new type of billing that i have been recently introduced too. I have a client who has recently opened her practice. I had to undo everything she did because the set up was not done correctly. Meaning she didn't have the correct TPI set up for Target Case Management to bill for SB54 billing which is skills training. Now that we have everything is place. I see that the coding is few.
Place of service will be in an office setting (11)
The patient will see an NP for assessment and diagnosis which I believe would be CPT 90791
After the NP refers the patient for counseling the patient will be seen for  counseling for targeted case management/skills training. I am wondering if that code would be T1017 or would it be another (9) code for all the other follow up visit for managing or monitoring or evaluation and management code.

Mind you I had the client to stop seeing patients until the set up of everything was done correctly (credentialing, CMBHS training, MCO contracts, paneling with commercial insurance, correct TPI for service with Medicaid etc)  because my client was seeing patient thinking she was ready to bill and not taking any cash pay, all patients were insurance. I can back bill for services per Medicaid from effective date 7/16 but I have 90 days to do so from our enrollment date which was 8/12/2017. Which I won't be able to do so until the NP is credentialed under the practice. I am trying to make sure I have all the correct information when it's time to bill for services so we can receive maximum reimbursement for services rendered without the possibility of being denied.

Can anyone help me out? Thank you.

Michele

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Re: Behavioral Health Billing
« Reply #1 on: August 30, 2017, 08:14:30 AM »
I assume your in Texas.  The term TPI isn't used anywhere else I don't believe. 

I have never billed for targeted case management/skills training but upon a little research I am finding only the T1017 code.  Did you check with TX Medicaid to see if the T1017 is a reimbursable code?
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PMRM

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Re: Behavioral Health Billing
« Reply #2 on: August 30, 2017, 02:35:14 PM »
Yes, Texas. Yes it is billable and used for reimbursement. And that was the only code that I could find even in the codes books. There are E/M as well but it depends on services rendered.

I was just wondering about the T1017 and will it be used for every follow up visit as well or would there be another one. I wanted to make sure I wasn't looking over anything.

Thanks for your response. I saw your question in the past about a year ago and it was similar to mine mine. Not sure if you ever got resolve on that.