General Discussion
In reply to the discussion: Mentally ill people.. [View all]cbdo2007
(9,213 posts)of the mental health population, those with high complexity and the most serious mental illnesses.
Starting in 2013, they have unbundled mental health services for psychiatrists so instead of billing for services that were previously bundled together (psychotherapy and med management), they will now bill two codes with the med management part being an E&M Code (instead of the old 90862 which was the med management code).
Unfortunately, the E&M Codes for the most complex cases cost many times more than the old 90862 code. For example, someone with the highest complexity level (still only 3% of mental health patients) they probably had an allowable of about $60 for a 90862. Now, for a 99215 they will have an allowable of $100 or more (I believe the CMS rate is >$140 for this service) so any members who have a coinsurance could now see that double.
Providers and the AMA say this is a parity issue but really it's just going to raise premiums and rates for their members.