Page Keywords: 96100 testing, 96101 testing, 96102 testing, 96103 testing, new psych testing codes
New Mental Health Testing Codes
 
Effective January 1, 2006, there are new testing codes that every behavioral health office should be using. There are no more grace periods to start using the new codes. You've been thrown back into those murky billing waters again and we'd like to be your lifeline.
Recent articles in several magazines have pointed out there are new codes for psychological testing. One of the deleted codes, 96100 has been a staple of the profession for many years. This change has prompted calls to our office and more questions. We understand your concerns. Just remember, change can be good thing.
Like the health and behavior assessment codes that were added back in 2002, we believe this change is positive since it paves the way for more accurate reporting and reimbursement. It also opens doors by allowing some testing services to be provided by qualified technicians and/or computers.
To assist you in making this change, InstaCode Institute has done the research so you know how to USE these codes in your practice. This research goes beyond just knowing the code numbers and their descriptions. It includes information on documentation changes that need to be made as well as how to assign appropriate fees for the new codes.
WHY NEW CODES
It all began with attempts to streamline the testing process. By adding technicians and having computers doing some of the testing, it reduced some of the time needed to complete a battery of tests. This would free up more time for revenue generating practices. However, this also created a negative effect on the fees paid to providers.
As a result, in the last few years, the American Psychological Association Practice Organization has been trying to establish a "professional work value" for testing and assessment codes. Professional work values have a great deal of impact on the amount paid by Medicare and other payors. (More detailed information on work values and fee establishment is contained in the Behavioral Health MultiBook). The bottom line is that clinicians who performed all testing "face-to-face" were being paid less because they were being paid at a rate that included work done by technicians and/or computers. The only way to increase the rate was to change the current code description so that work done by a professional was distinguished from work done by technicians or computers.
IMPACT ON FEES
Now that the codes have been divided up, and the RVUs (relative value units) have been released, it appears that the professional work component has been increased and fees should go up accordingly. However, with the proposed 4.4% pay cut by Medicare, this increase will have a smaller effect than if Medicare had not cut their reimbursement rate. The good news is that this RVU increase overwhelms the pay cut, resulting in a significant increase in your reimbursement by using the new code for testing done by a professional.
It should be noted that Medicare payment policies are quite often used as a litmus for the rest of the insurance payors in the marketplace. Therefore, in all likelihood, other payors will increase their reimbursement rates as well. Because the codes are new, each payor will establish their own policies and procedures on using these new codes.
The only down side is that fees will decrease for work done by a technician or computer. However, this was an expected effect since work done by technicians or computers has a lower work value.
DOCUMENTATION IMPACT
Another impact that the new codes will have will be in the patient record. For reimbursement and auditing purposes, patient records need to be specific on which testing was done, by whom, and for how long. No longer will it be sufficient to state that there was 5 hours of testing.
GET READY..GET SET..GO!
The 2006 edition of the Behavioral Health MultiBook includes practical information on helping your office get set and ready to go on January 1st. It includes coding examples, guidelines, and fee information on using these new codes and others as well.
Click here to read more about the Behavioral Health MultiBook.
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Page Title: New Mental Health Testing Codes - 96100 testing, 96101, 96102, 96103, new psych testing codes, new psych testing codes
Page Keywords: 96100 testing, 96101 testing, 96102 testing, 96103 testing, new psych testing codes
Page Summary: New Mental Health Testing Codes - 96100 testing, 96101 testing, 96102 testing,96103 testing,new psych testing codes - Behavioral Health MultiBook - psychology billing, Excerpts for Behavioral Health from the following books: DSM-IV-TR diagnostic criteria, CPT procedures, ICD-9 diagnosis, HCPCS supplies. We also included sections on: Insurance Claims (sample forms, how to bill different payors, What is a "clean claim"?), Fees (RVU based fee analysis), and Resources (HIPPA Compliance, Avoiding Fraud & Abuse, E&M Services, ICD-10 Preview)
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