Medicare Information 2013

Beginning in 2013 the reimbursement rate for Medicare providers will increase to 65% of the allowed rates for mental health services.  Also, the Medicare deductible for your clients will increase to $147 at the beginning of 2013.

Magellan has updated preauthorization policy

Effective January 1, 2013, Magellan Health Services will no longer require preauthorization or submitting treatment request forms for routine outpatient care for most plans.   Magellan hopes to streamline clinical management for outpatient treatment in order to help their members get access to the care they need.   This policy does not apply to inpatient, residential or partial hospitalization.   For more information and plan exceptions to this new model providers can securely sign into www.magellanhealth.com/provider.

eNewsletter

T & T is rolling out it's first issue of our eNewsletter specifically for our providers.   For those that visit the blog but would also like to be on the mailing list for in depth information pertaining to your specialty contact us at info@ttmedbill.com and in the subject line type eNewsletter and we will add your email address to the mailings.  Thank you all in advance for your support!

New Psychotherapy CPT codes for 2013

The psychiatric Current Procedural Terminology (CPT) codes are expected to change January 1, 2013.  From the looks of things there will be around a dozen new codes that will replace codes that are currently being used.   Most codes will apply to psychotherapy but there are a few that pertain to E/M and medication management  for psychiatrists.  The updated coding will now be used in all places of service.  T & T will have more on these updates as they are released.   Visit http://www.psych.org/practice/managing-a-practice/coding--reimbursement/changes-to-psychiatry-cpt-codes  in the mean time for more information about these changes.

UPDATE:  Here is the link to the published 2013 CPT codes for mental health providers http://www.apapracticecentral.org/reimbursement/billing/psychotherapy-codes.pdf.  T & T will be sending out a detailed newsletter later this year to our providers outlining the codes with descriptions on how to best utilize the new codes for maximum reimbursement from insurance companies.  Providers will want to contact the provider relations department at the insurance companies where they participate to get updated fee schedules for their contracts.

GHI HMO/HIP

Effective January 1, 2012 ( I realize I'm a little late with this one), Emblem Health replaces GHI HMO and HIP policies.  The mental health and substance abuse vendor for these plans are now Value Options.  Benefits and eligibility can be obtained by calling 800 235-3149.  The claims address is P.O. Box 803, Latham, NY 12110

ICD-10 Compliance postponed

CMS has just issued a press release indicating the compliance deadline for the implementation of the ICD-10 standards has been delayed one year.   ICD-10 compliance is now delayed until October 1, 2014.  For more information visit:  http://www.ofr.gov/OFRUpload/OFRData/2012-21238_PI.pdf