As most of you are aware, 2013 is bringing with it many changes in procedural coding that will affect all mental health providers. The changes were hinted at last summer, but not officially mandated until last month, giving the mental health
industry less than two months to learn the coding, decide on accepting
fee schedules, and make the necessary software changes. It is an
absolutely ludicrous amount of time, but despite petitions to delay the
changes until summer, it looks like it's going ahead on schedule, giving
many the sense that they are being set up to fail. In addition, many
commercial insurance carriers will not be ready to accept the new codes
on January 1st. The changes will be an especially onerous task for
psychiatrists who, in addition to psychotherapy coding changes, will now
have the opportunity to finally use medical codes as an adjunct to
psychotherapy codes, thus being able to more accurately report the
services they are providing. However, the APA acknowledges that this big
change -- finally real parity -- will come with many bumps along the way.
All mental health
providers will be using a new set of procedure codes to report
psychotherapy services, with the exception of collateral visits for
which the codes remain the same (90846-47). The biggest and best change
is that now a 60-minute code has been added which can be used in many
treatment scenarios.
For psychiatrists, the biggest change is a that the medication management
code (90862) has been deleted. Psychiatrists will now have the opportunity
to use "Evaluation and Management" codes (E&M) and use a
secondary procedure code to report psychotherapy done during that same
visit.
Out greatest concern is to make sure that our clients are reimbursed
quickly and accurately, but we depend on third party payers to abide by the
same mandates as providers and billers do. Many of these payers,
including mental health
"carve out" plans are simply not ready for the changes; authorizations
are still being issued with the 2012 procedure codes, and they do not
even recognize E& M codes. It's pretty easy to imagine the problems
ahead.
The good news is that once the dust settles, it looks like reimbursements for all levels of mental health providers will be higher.
We at PBS, have taken classes to help us to assist our clients with the
many complexities that are coming in 2013. We urge you to purchase the
2013 CPT manual, and take any classes/workshops offered by your
professional societies.
