Reimbursement Rates

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PRAC-6670-21-PMH NP Role II: Adult-QTR-Term-wks-1-thru-11-(03/01/2021-05/16/2021)-PT27•SafeAssign Drafts•Submitted on Mon, Apr 19, 2021, 12:47 PMView Originality Report - Old Design

Lydia Otoo

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Reimbursement Rate Template

Lydia Otoo

Walden University

April 19, 2021

NURS 6670

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Reimbursement Rate Template The reimbursement rates that are used by mental health practitioners are different from those that are used by other practitioners in the health care system. While psychiatric care providers are offered limited financial support, other medical practitioners have access to large financial support enabling them to afford large offices and staff (O’Donnell, Williams, & Kilbourne, 2013). This disparity means that the mental health department has a stretched budget that makes it impossible for the practitioners to effectively execute their professional mandate. Furthermore, the mental health department collects less money that is owed from insurance companies (Kohler, 2015). This document will carry out an analysis of different mental health treatments that I can implement at my workstation. Type of Service

eg.

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-New office visit -Established office visit -Inpatient hospital -individual psychotherapy -group psychotherapy (see examples below) CPT code Private insurer reimbursement rate for PMHNP Private insurer reimbursement rate for physicians Medicare reimbursement rate for PMHNP Medicare reimbursement rate for physician Psychiatric diagnostic evaluation 90791 $ 80.60 $94.90 $114.60 $155.70 Psychotherapy, 60 minutes with patient and/or family member 90837 $ 83 $89 $112 $116 Individual psychotherapy30 minutes with patient and/or family member 90832 $46 $53.10 $55.96 $ 51.10 Psychotherapy, 45 minutes with patient and/or family member 90834 $64 $65.50 $74.40 $92.80 Group psychotherapy (other than of a multiple-family

group)

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90835 $19.30 $ 20.80 $22.50 $25.30

References

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https://www.psychiatry.org/psychiatrists/practice/practice-management/coding-reimbursement-medicare-and-medicaid/coding-and-reimbursement http://www.mb-guide.org/medical-coding-guidelines.html

O’Donnell, A.

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N., Williams, M., & Kilbourne, A.

M.

(2013).

Overcoming Roadblocks:

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Current and Emerging Reimbursement Strategies for Integrated Mental Health Services in Primary Care. Journal of General Internal Medicine, 28(12), 1667-1672. doi:10.1007/s11606-013-2496-z Kohler, C.

(2015).

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Physician Practice Billing From A to Z.

Brentwood, TN:

HCPro, a

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division of BLR.

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