Behavioral Health

Supplies Resources (Resource 347)

Providing medical supplies to your patients can benefit both the patient and your practice. However, there are specific protocols that need to be followed in order to properly bill supplies. Not only do the proper codes need to be selected, but the appropriate use of modifiers is essential. Also, some payers have their own specific requirements that must be followed. For information on codes and modifiers, refer to Section I-Supply Codes of the Behavioral Health MultiBook.

Links:

TENS Rentals

Q: How do you submit TENS (Transcutaneous Electrical Nerve Stimulation) rentals for reimbursement? I have some insurance companies that pay without question and others that deny this.

A:Use the correct TENS unit code, either E0720 for two lead or E0730 for four lead, and append the modifier -RR to designate Rental. Example E0720-RR.

Other popular supply modifiers include -NU to signify a new product and -UE to signify the sale of a used product.

Provider Non-Discrimination FAQ by CMS

Medicare understands that there are individuals who may not meet the diagnostic criteria for substance abuse, but who are still at risk. To help identify these individuals and take steps to keep them from reaching the level of abuse, Medicare has established a program called the Screening, Brief Intervention, and Referral to Treatment (SBIRT) Services.

Health and Human Services Secretary Sylvia M. Burwell announced today $99 million to train new mental health providers, help teachers and others recognize mental health issues in youth and connect them to help, and increase access to mental health services for young people.

Read the article here: HHS.gov

Questions and Answers for Psychologists and PQRS. In 2007, Psychologists had very limited opportunity to participate in PQRS. As of 2014, there are 11 measures available for claims-based reporting and two for registry reporting.  

For the entire article read more here: PracticeCentral.org

Below are the 11 new measures for 2014

Integrated healthcare is a part of Health Care Reform, it is a coordinated approach between Primary Care Providers and Behavioral health providers. This program is to detect, treat and ensure follow up for mental and physical conditions.

Telehealth Psychiatric Service (Resource 283)

Telehealth (also known as telemedicine) is playing an ever increasing roll in the reimbursement process. Internet services continue to expand and many insurance payers/providers are now covering (paying for) telehealth services. Telepsychiatry (providing behavioral health services in a telehealth environment) has been highly successful because video conferencing makes providing psych services as realitvely simply and inexpensive process.

The SAMHSA-HRSA Center for Integrated Health Solutions (CIHS) promotes the development of integrated primary and behavioral health services to better address the needs of individuals with mental health and substance use conditions, whether seen in specialty behavioral health or primary care provider settings. CIHS is the first “national home” for information, experts, and other resources dedicated to bidirectional integration of behavioral health and primary care.

 

Most of us have seen the news reports on problems of veterans seeking healthcare benefits through the Department of Veterans Affairs. Several factors such as the misuse of funds and controversial bonus systems seem to have combined to create this current newsworthy crisis. Critics argue that the VA's performance bonus system created financial incentives for managers to hide the true number of patient's on their waiting lists. Whistleblower claims are backing up this argument. The fact that many veterans have died while on waiting lists has fueled this crisis.

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