Cashing in on Care
The Top Reimbursing Services for Mental Health Providers
The world of mental health is vast, with a myriad of treatment modalities and therapeutic interventions available. As awareness surrounding mental health grows, so does the demand for services, and with it, the potential for lucrative reimbursement. However, to maximize revenue, mental health providers must be aware of the top reimbursing services. This knowledge ensures that they remain competitive while offering the highest quality care. In this blog post, we shed light on the most rewarding services for mental health providers.
1. Psychiatric Diagnostic Evaluation:
Billing Codes: 90791 (without medical services) and 90792 (with medical services).
Why It’s Lucrative: This is the foundational assessment for determining mental health disorders, often billed at the onset of treatment. It’s thorough and requires a significant amount of the provider’s time, making it a higher reimbursing service.
2. Psychotherapy (60 minutes):
Billing Code: 90837
Why It’s Lucrative: An hour-long session allows the provider to delve deeper into the therapeutic process. While the 45-minute session (90834) is more common, the 60-minute session offers better reimbursement rates.
3. Psychological and Neuropsychological Testing:
Billing Codes: 96130-96133 for psychological testing and 96136-96139 for neuropsychological testing.
Why It’s Lucrative: Such evaluations often involve multiple hours of testing, scoring, interpretation, and report writing. Due to the complexity and time commitment, these services tend to have higher reimbursement rates.
4. E/M (Evaluation and Management) Services with Psychotherapy Add-on:
Billing Codes: 99201-99215 for E/M services with the addition of 90833 (30 min), 90836 (45 min), or 90838 (60 min) for psychotherapy.
Why It’s Lucrative: When a provider delivers both evaluation/management and psychotherapy services in a single visit, combining these codes results in higher reimbursement.
5. Group Psychotherapy:
Billing Code: 90853
Why It’s Lucrative: While the reimbursement per individual might be lower than one-on-one sessions, the cumulative payment for the group can be substantial, especially if the group reaches capacity.
6. Telehealth Psychotherapy Services:
Billing Codes: 90791 or 90834/90837 with the telehealth modifier (usually GT or 95, depending on the payer).
Why It’s Lucrative: With the rise of telehealth, especially during the COVID-19 pandemic, reimbursement rates have become more competitive. These services eliminate geographical barriers, allowing providers to expand their clientele.
7. Pharmacologic Management:
Billing Code: 90863
Why It’s Lucrative: For psychiatric providers who prescribe medication, this service involves evaluating the effects of the medication, possible side effects, and making any necessary changes. It’s an essential aspect of treatment for many patients and commands a higher reimbursement rate.
Conclusion:
Mental health is a rewarding field both in terms of its impact on patients’ lives and potential financial benefits. By familiarizing themselves with top reimbursing services, mental health providers can optimize their practice for both effective patient care and robust financial health. It’s essential, however, to always prioritize patients’ needs and ensure that billing practices are ethical and reflective of genuine therapeutic interventions.