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Behavioral Health|Psychiatry|Psychology - Articles

Finalized Confidentiality of Alcohol and Drug Abuse Patient Records Regulations
August 31st, 2018 - Wyn Staheli, Director of Research
In January, the U.S. Department of Health and Human Services (HHS) issued updates to the privacy regulations regarding the confidentiality of patient information of substance use disorder patients (42 CFR Part 2).  This notice included references to better alignment with HIPAA regulations, but did state that Part 2 is more protective ...
Importance of Depression Screenings
August 16th, 2018 - Wyn Staheli, Director of Research
Why would a chiropractor be concerned about depression screenings when you aren’t trained to be a mental health provider? The answer lies in patient outcomes. Many quality care organizations recommend depression screenings for patients with a chronic condition. According to The National Institute of Mental Health, “People with other chronic ...
Payment Rates Increase for Behavioral Health Office Services
February 13th, 2018 - Wyn Staheli, Director of Research
Behavioral health providers may see some improvement in payment rates for office-based behavioral health services. This is due to the fact that the overhead expense evaluation portion of the RVU was increased. The following information is from the Federal Register (see References): We agree with these stakeholders that the site of service ...
Psychiatric Partial Hospitalization Programs
January 25th, 2018 - Wyn Staheli, Director of Research
Psychiatric Partial Hospitalization Programs (PHPs) are a more comprehensive level of care than Intensive Outpatient Programs (IOPs - click here to read more about IOPs). When the patient requires a minimum of 20 hours per week and hospitalization is not clinically indicated, a PHP can be the most effective type of ...
Intensive Outpatient Treatment (IOP)
January 11th, 2018 - Wyn Staheli, Director of Research
Intensive Outpatient Programs (IOPs) are considered to be an intermediate level of care which is commonly considered after the patient has been discharged from inpatient care. For some patients and/or conditions they can also provide an effective level of care when hospitalization is not clinically indicated or preferred. The following ...
Medicare Improper Payment Report for Behavioral Health Services (2016)
September 1st, 2017 - Wyn Staheli
The Medicare Improper Payment Report for 2016 has been released by the OIG. Please note that the improper payment rate does not measure fraud. Rather, it estimates the payments that did not meet Medicare coverage, coding, and billing rules. The estimated Medicare FFS payment accuracy rate (claims paid correctly) from ...
Proposed Telehealth Changes for 2018
August 4th, 2017 - Wyn Staheli
Medicare has proposed making some changes to policies regarding telehealth services. They are adding some new codes to their covered list of telehealth services and propose eliminating the requirement to use the GT modifier. Since many payers adopt similar policies, watch for further announcements...
New payments for Psychiatric Collaborative Care Services (COCM) from Medicare
June 29th, 2017 - Chris Woolstenhulme, CPC, CMRS
Medicare has agreed to make separate payments to physicians and non-physicians for Behavioral Health Integration (BHI) services beginning Jan. 1st, 2017. Any condition new or pre-existing behavioral health or substance use disorders are eligible. Beneficiaries may have comorbid, chronic, or other medical conditions they are being treated for as well. Using the ...
Psychiatric / Psychological Testing with Bill Type 12X
June 23rd, 2017 - Chris Woolstenhulme, CPC, CMRS
Providers submitting claims with bill type 12X are to report revenue code 0918 (psychiatric / psychological testing). Note: Revenue codes do not apply to physicians; other professionals and suppliers bill these services to the Part B MAC They are used only with providers who bill these services to the fiscal intermediary or Part ...
Diagnostic Criteria for Behavioral Health
February 16th, 2017 - Wyn Staheli
In order to arrive at a diagnosis and check for related complications, a healthcare provider needs to evaluate the patient condition. This may include: History: This can include the patient's personal history as well as that of the patient's family. Physical exam: The healthcare provider will try to rule out physical problems ...
Psychotherapy Notes Provision of HIPAA
February 2nd, 2017 - Wyn Staheli
Of special interest to all behavioral health practitioners (both Covered Entities and NON-covered entities) is HIPAA's provision for psychotherapy notes. The privacy rule recognizes that psychotherapy notes need more protection than other types of PHI. Even if you are not a covered entity, we recommend understanding and implementing office procedures ...
Medicare Coverage of Behavioral Health Services
February 1st, 2017 - Wyn Staheli
Medicare's coverage of mental health services is based upon the medical necessity as defined within the Medicare Benefits Policy Manual and the Local Coverage Determinations (LCDs). It should also be noted that not all types of providers may perform all Medicare covered services. For example, an...
G-Codes eff Jan 01,2017 for additional payment for Psych - Collaborative Care
January 2nd, 2017 - Chris Woolstenhulme, CPC, CMRS
Medicare has agreed to make separate payments to physicians and non-physicians for Behavioral Health Integration (BHI) services beginning Jan. 01, 2017. Any condition new or pre-existing behavioral health or substance use disorders are eligible. Beneficiaries may have comorbid, chronic, or other medical conditions they are being treated for as well. Using the ...

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