New Mental Health Procedure Codes- Reimbursement Cuts

The mental health procedure codes used by insurance companies are being revised, and will be reimbursed at a different rate. While some codes stay the same, one of the changes that will lead to a cut in pay for most therapists, and a cut in service for most mental health patients, is the code for outpatient psychotherapy.

The old code of 90806 was used by most therapists and was reimbursed for the typical 50 or 55 minute therapy session. However the way the new codes are set up, if a 50 minute session is preauthorized (and that is the way blue cross and many other insurers do it), then you are expected to round down to 45 minutes, and that session is equivalent to the old 90804, paid at a much lower rate of reimbursement.

This is a hidden pay cut and service cut, for therapists and clients respectively. If therapist usually takes the whole hour (adding time at the end for record keeping), then the new rules will try to force them to do 45 minute session, (or donate the time) seeing three patients over a little over two hours, if they plan to make as much or more money as in the previous system, when they saw two patients in that time.

So far the actual reimbursement rates have yet to be published although they were due in November. Hopefully that will include an increase, but the projection is for a cut in reimbursement, when both are taken into account. I still make less from an insurance company now than I did in the 1980’s, and that is one reason many of my colleagues do not fool with insurance.

 

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Published in: on November 28, 2012 at 5:23 pm  Comments (1)  
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General Hospitable- Soap Opera Surges

I am rather amused that everyone seems so obsessed about who General Petraeus is sleeping with or sharing his smiley faces by email.  This whole affair is more like a soap opera than a real issue, worthy of public debate. It is a reality show run amuck. I think they could have a Bachelor Pad type set up on a middle east base, with the top brass and their wives/girlfriends, complete with candid footage shot by drone.  American viewers could vote them off one at a time, until the last general and his partner get to be Chairman of the Joint Chiefs.

I for one am pleased that the real surge included women in a support role, but I think we would be better off if we put the women in charge of the military ansd politcal choices, especially when it comes to conflict. Men can be so alpha, and the last thing the military needs is a few alpha men trying to “one up” each other. This is, I think, the best argument I have heard in a long time, for cutting military spending.

I really thought the days of J. Edgar Hoover were over, when  the FBI had dossiers on all the politicians and could use them as they please, to end or build someone’s careers. This was the slippery slope we started back down when we made getting a warrant unncessary during the Bush and Cheney era. Everybody said, “hey, don’t worry, it will only be used against terrorists.” 

I did not  really expect to see Petraeus and Ossama Bin Laden given the same protections (none) and now we know that the agencies with access to emails and other personal communications will use them to curry favor, and to tarnish rivals.

If they can snoop and blackmail when it comes to flirtations, custody battles, and affairs, who really believes that it won’t also be done for financial and/or political gain? I want my constitution back, especially my rights to privacy.