A Comprehensive Guide for Mental Health Billing- Part 2
In Comprehensive Guide for Mental Health Billing- Part 1, we covered mental health service providers and their area of expertise. In part 2 we will be discussing different types of mental health services and who are authorized to provide them.
Providers and Types of Services
This means that insurance will only cover mental health services if they are provided by a certain type of mental health provider. For example, Medicare allows the following providers to bill for diagnostic and therapeutic treatment: Physicians, Psychiatrists, Clinical psychologists, Clinical social workers, Clinical nurse specialists, Nurse practitioners, and Physician Assistants. These providers can only bill for mental, psychoneurotic, and personality disorders. On the other hand, independent psychologists and non-clinical psychologists can only provide diagnostic services.
What this means is that Medicare will only pay an independent psychologist to diagnose a patient with a mental disorder, and not to continue treating the patient with the mental disorder. If you are a physician or psychiatrist, on the other hand, Medicare will pay for you to diagnose and treat the patient with the mental disorder.
Mental health services are all similar, due to the fact that they are almost all performed as a type of counseling service. Because of this, there is not a very large amount of codes that you can bill for mental health services.
Related Article: A COMPREHENSIVE GUIDE FOR MENTAL HEALTH BILLING- PART 1
Types of Mental Health Services
- Psychiatric Diagnostic Interview
This interview is an examination of the patient’s entire medical and mental health history, completion of a mental health status exam, an establishment of a provisional diagnosis, and an evaluation of the patient’s willingness and ability to help solve the mental health problem. When this interview is performed on children, it is performed using physical aids and non-verbal communication, such as with play equipment. The two codes that are reported for these services are:
90801: Psychiatric diagnostic interview examination
90802: Interactive psychiatric diagnostic interview examination
- Psychiatric Therapeutic Services
Individual psychotherapy is rendered to people who have the ability to understand and respond meaningfully to a provider’s questions and comments. This communication is meant to help get rid of emotional disturbances, change patterns of behavior, and help the individual live a more normal healthy life. Following codes represent what most people think of as therapy by a psychiatrist.
90804-90809: Insight-oriented, behavior modifying and/or supportive psychotherapy
90810-90815: Interactive psychotherapy
While reporting these codes, you have to keep in mind the type of psychotherapy, the place of treatment, the time spent with the patient, and whether an examination was also provided on the same date of service.
- Family Medical Psychotherapy
Sometimes, a therapist or psychiatrist will provide therapy sessions to a patient’s family, whether or not the patient is actually present. This service is sometimes considered for payment by the insurance company, depending on the situation, and documentation that it was a medically necessary service.
Realted Article: COMPREHENSIVE GUIDE FOR MENTAL HEALTH BILLING- PART 3
These services are provided to help the patient’s family understand the patient’s condition and to educate them on how to help the patient alleviate their condition, or to help them create and stick to a plan of care. One of the important things to remember about Family Psychotherapy is that in order for the service to be covered, the group being counseled must meet the definition of family. That is, immediate family members, such as spouse, children, grandchildren, parents, grandparents, or primary caregivers or health care proxy. The code ranges for these services are:
90846: Family psychotherapy (without the patient present)
90847: Family psychotherapy (with the patient present)
90849: Multiple-family group psychotherapy
- Group Psychotherapy
In group psychotherapy, a provider selects a specific group of patients to treat together as a group, for the purpose of helping all members of the group change patterns of behavior. The code ranges for these services include:
90853: Group psychotherapy (other than a multiple-family group)
90857: Interactive group psychotherapy
As long as all of the mental diagnoses are considered treatable, and that the mental health service is considered medically necessary, then the medical insurance should pay for the mental health services as listed above.
Under this blog series of a comprehensive guide for mental health billing, we will be covering all aspects of mental health billing. E2E Medical Billing Services is assisting mental health providers for more than 05 years now. To know more about our services you can call us at 888-552-1290 or email us at [email protected]