Posted: December 22nd, 2022
Current Procedural Terminology (CPT) Assignment
Assignment 2: Week 6 Practicum Journal: Reimbursement Rates Reimbursement rates and medical coding can be almost as complicated as treating some mental illnesses. As a PMHNP, you will be faced with varying rates that may be different than other health care
Assignment 2: Week 6 Practicum Journal: Reimbursement Rates Reimbursement rates and medical coding can be almost as complicated as treating some mental illnesses. As a PMHNP, you will be faced with varying rates that may be different than other health care providers you may work with. In this Practicum Journal Assignment, you will analyze reimbursement rates for mental health treatments you will likely use in your practice and compare those rates to other provider rates. Learning Objectives Students will: •Analyze reimbursement rates for mental health treatments To prepare for this Practicum Journal: •Research reimbursement rates for various treatment modalities. •Compare NP rates to other provider rates. For this Practicum Journal: Complete the Reimbursement Rate Template in your Learning Resources using the five types of services you are likely to use in your practice. Current Procedural Terminology (CPT) Assignment
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Assignment 2: Week 6 Practicum Journal
Current Procedural Terminology (CPT) is the system used by third-party payers to describe the provided healthcare services in numerical codes in order to be reimbursed by Medicaid or other insurances. CPT codes provide a uniform language to describe the provided medical services to ensure an understanding between medical practitioners, third-party payers, and patients as well(Leslie-Mazwi et al, 2016). Mental health practitioners have different billing requirements when compared to other health practitioners. The psychiatric CPT codes are used to bill for certain mental health services.in addition, CPT codes are used in describing both inpatient and outpatient psychiatric services (Leslie-Mazwi et al, 2016). This assignment provides an analysis of reimbursement rates for five mental health services likely to be used during my practice. Finally, the paper will provide a comparison of the reimbursement rates for PMHNP with those of physicians. Current Procedural Terminology (CPT) Assignment
90834: This code is used to psychotherapy provided to the patient alone or together with the family members. However, even if the family members may take part in the psychotherapy, the patient is supposed to be always present or attend most of the psychotherapy services. As long as the client attends most of the psychotherapy sessions, time spent with the family members even though the client is not present is included in the time prerequisite for choosing the code (American Psychiatric Association, 2019). The code covers psychotherapy provided for 45 minutes.
90791: This code is used to bill individual diagnostic evaluations that the patient undergoes but does not include the medical care services provided. The diagnostic evaluations covered by this code include the chief complaint; history of present illness; MSE, review of systems, family history, medical history, and examination of the diagnostic findings (Katz & Eileen, 2018). Current Procedural Terminology (CPT) Assignment
90833: Just like code 90834, this code is used to bill psychotherapy provided with the patient, together with the family member(s). The client is required to attend all or the majority of the psychotherapy sessions. This code is used to bill psychotherapy provided to the client and (or) family member(s) for 30 minutes.
90847: This code is used to bill telephone of face-to-face or psychotherapy services provided to the family in presence of the patient for 26 minutes or more (American Medical Association, 2018). Family therapy refers to the psychotherapy that is aimed to assist the family members in improving communication and resolving conflicts in order to facilitate the patient’s recovery (Katz & Eileen, 2018).
90836: This code is used to bill individual psychotherapy that is aimed to modify behavior and provide support to the client. The psychotherapy session is provided to the client with or without the family member for 45 minutes. The time range allowed for this code is 38-52 minutes. Lastly, the psychotherapy should be provided together with assessment and management services for the client (American Psychiatric Association, 2019). Current Procedural Terminology (CPT) Assignment
American Medical Association (2018).CPT Primer for Psychiatrists.https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&uact=8&ved=2ahUKEwjZxczGkIPeAhVKYxoKHe3cB2sQFjABegQICBAC&url=https%3A%2F%2Fwww.psychiatry.org%2FFile%2520Library%2FPsychiatrists%2FPractice%2FPractice-Management%2FCoding-Reimbursement-Medicare-Medicaid%2FCoding-Reimbursement%2Fcpt-primer-forpsychiatrists.pdf&usg=AOvVaw33lNu6gqIxM0Q30aXmd2tu
Katz S & Eileen P. (2018). Update on Relative Value Units and the Cognitive Physician Visit. Gastroenterology Hepatol (N Y). 14(1), 41–43.
Leslie-Mazwi T, Nicola G, Donovan W &Barr H. (2016).Current Procedural Terminology: History, Structure, and Relationship to Valuation for the Neuroradiologist. American Journal of Neuroradiology.37 (11), 1972-1976. Current Procedural Terminology (CPT) Assignment
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