Reimbursement rates
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.
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
As the PMHNP becomes proficient in diagnosing and treating, it is also important to learn how to bill for your time. The CMS sets up codes to identify the type of service you are providing. You will generally complete this task at the end of the visit as you are documenting the visit with the client. Here are examples of the codes to know:
CPT Codes for Psychiatric and Psychological Procedures
HMSA recognizes the following service codes for the reporting of psychiatric and psychological services. (See Code Books for information on how to obtain the books.)
CPT Code
Footnote(s)
Description
90791
1
Psychiatric diagnostic evaluation
90792
1,3
Psychiatric diagnostic evaluation with medical services
90832
2
Psychotherapy, 30 minutes with patient and/or family member
90833
2,3
Psychotherapy, 30 minutes with patient and/or family member when performed with an evaluation and management service
90834
4
Psychotherapy, 45 minutes with patient and/or family member
90836
3,4
Psychotherapy, 45 minutes with patient and/or family member when performed with an evaluation and management service
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