2 pages within 12 hrs
ltdprinwival
week_6_assignment_2_rates_.docx
Student Name:
Practicum Placement Agency's Name:
Preceptor’s Name:
Preceptor’s Telephone:
Journal Entries
This journal assignment is used to look up reimbursement rates for private insurance as well as Medicare for physicians and nurse practitioners. I have searched and found some of the rates for the services I will be mostly providing in the inpatient setting. Reimbursement involves more than just what is paid; it is a process that begins when the patient contacts the office for initial assessment. As a provider, it is imperative to understand the basics, including correct coding. Having a good concept of Medicare basics will help because private policies tend to base their reimbursement rates and policy on Medicare information, (Beck & Margolin, 2013).
NURS 6670
Reimbursement Rate Template
|
Type of Service eg. -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 |
$80.61 |
$94.84 |
102-127.50 |
120-150 |
|
Psychotherapy, 30 minutes with patient and/or family member
|
90832 |
$73.20 |
$86.12 |
90.88 |
106.92 |
|
Family psychotherapy (without the patient present)
|
90846 |
78.51 |
92.37 |
54.16 |
63.72 |
|
Psychotherapy, 60 minutes with patient and/or family member
|
90837 |
33.12 |
38.97 |
108.63 |
127.80 |
|
Group psychotherapy (other than of a multiple-family group)
|
90583 |
19.57 |
23.02 |
56.61 |
66.60 |
AANP - Fact Sheet: Medicare Reimbursement. (2013). Retrieved from http://www.aanp.org/legislation-regulation/federal-legislation/medicare/68-articles/325-medicare-reimbursement
Beck, D. E., & Margolin, D. A. (2007). Physician Coding and Reimbursement. The Ochsner Journal, 7(1), 8–15.
