1. Week 6 Practicum Journal: Reimbursement Rates
Week 6 Practicum Journal: Reimbursement RatesWeek 6 Practicum Journal:
Reimbursement RatesReimbursement 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.ORDER COMPREHENSIVE SOLUTION PAPERS ON Week 6 Practicum Journal:
Reimbursement RatesLearning ObjectivesStudents will:· Analyze reimbursement rates for
mental health treatmentsTo 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
6670Reimbursement Rate Template Type of Serviceeg. -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 Medicarereimbursement rate for PMHNP
Medicarereimbursement 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) Description90791 1 Psychiatric diagnostic
evaluation90792 1,3 Psychiatric diagnostic evaluation with medical
services90832 2 Psychotherapy, 30 minutes with patient and/or family
member90833 2,3 Psychotherapy, 30 minutes with patient and/or family member
when performed with an evaluation and management service90834 4
Psychotherapy, 45 minutes with patient and/or family member90836 3,4
Psychotherapy, 45 minutes with patient and/or family member when performed
with an evaluation and management service90837 6 Psychotherapy, 60 minutes
2. with patient and/or family member90838 3,6 Psychotherapy, 60 minutes with
patient and/or family member when performed with an evaluation and management
service90839 6 Psychotherapy for crisis; first 60 minutes90840 2 each
additional 30 minutes90846 4 Family psychotherapy (without the patient
present)908474 Family psychotherapy (conjoint psychotherapy) (with patient
present)908494 Multiple-family group psychotherapy90853 4 Group
psychotherapy (other than of a multiple-family group)90870 1, 5 Electroconvulsive
therapy (includes necessary monitoring)96101 1 Psychological testing
(includes psychodiagnostic assessment of personality, psychopathology, emotionality,
intellectual abilities, e.g., WAIS-R, Rorschach, MMPI) with interpretation and report, per
hour. Note: All hours of psychological testing done on a single day will be counted as one
visit (either inpatient or outpatient as appropriate) toward the patient’s inpatient or
outpatient visit maximum. However, payment will be made to the participating provider on
a per-hour basis.96118 1 Neuropsychological testing battery (e.g., Halstead-
Reitan, Luria, WAIS-R) with interpretation and report, per hour Note: All hours of
psychological testing done on a single day will be counted as one visit (either inpatient or
outpatient as appropriate) toward the patient’s inpatient or outpatient visit maximum.
However, payment will be made to the participating provider on a per-hour basis. Links to
websites that discuss this:https://www.psychiatry.org/psychiatrists/practice/practice-
management/coding-reimbursement-medicare-and-medicaid/coding-and-
reimbursementhttp://www.mb-guide.org/medical-coding-guidelines.html
