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Billing Tools

Paying for Primary Care and Behavioral Health Services Provided in Integrated Care Settings



State Billing and Financial Worksheets

Financing is often perceived as one the three biggest barriers to sustainable integration activities. By not billing at all, or billing incorrectly, providers risk denied or delayed claims payments, wasted time and resources, and missed reimbursement opportunities for services provided.

CIHS compiled these state billing worksheets to help clinic managers, integrated care project directors, and billing/coding staff at community mental health centers and community health centers identify the available current procedural terminology (CPT) codes they can use in their state to bill for services related to integrated primary and behavioral health care.

You can use these worksheets to review these codes against all activities currently billed to ensure your organization is aware of all potential billing opportunities to maximize revenue and sustain integrated care.
Changes to the updated worksheets include:
• Updated CPT codes
• States with services billable by peer support specialists
• Updates to same-day billing allowances
• New states with telemedicine codes
• SBIRT Codes
• Medicare obesity and tobacco counseling codes

CPT and diagnostic codes are consistent across the country; however, state Medicaid programs determine the types of services, codes, and individuals credentialed to provide services, resulting in unique billing rules and regulations in each state. The worksheets link CPT codes with the state-specific diagnostic codes and associated professional credentials needed to submit a successful, payable claim.

CIHS reviewed source material from the state Medicaid offices to identify billing codes and credential requirements. When the information was not clearly available, CIHS contacted the state authorities directly to receive the source material for the updated codes.

Please note: Information in these worksheets is current as of July 2014. Billing codes may change as states change their Medicaid programs. Please verify the information with your state or local billing authorities if you have questions. Please communicate changes affecting your state’s billing guidelines to CIHS.


Billing tools & resources

The medical billing and coding certification homepage features 65 short, instructional videos, all vetted by professionals in the healthcare field, which cover a wide range of billing and coding topics.

WEBINARS

Billing for Integrated Health Services
Financing integrated healthcare is one of the key challenges encountered by organizations during implementation of services. This webinar featured the state based Interim Billing and Financial Worksheets developed by CIHS. The webinar addresses the core aspects of billing for integrated health services and assist participants in successfully using the worksheets to maximize billing opportunities for integrated health services.

June 12, 2012
Presented by Kathleen Reynolds


June 12, 2012
Presented by Kathleen Reynolds

Recording

Presentation

Transcript

Call Our Helpline: 202-268-7457

Paying for Primary Care and Behavioral Health Services Provided in Integrated Care Settings



State Billing and Financial Worksheets

Financing is often perceived as one the three biggest barriers to sustainable integration activities. By not billing at all, or billing incorrectly, providers risk denied or delayed claims payments, wasted time and resources, and missed reimbursement opportunities for services provided.

CIHS compiled these state billing worksheets to help clinic managers, integrated care project directors, and billing/coding staff at community mental health centers and community health centers identify the available current procedural terminology (CPT) codes they can use in their state to bill for services related to integrated primary and behavioral health care.

You can use these worksheets to review these codes against all activities currently billed to ensure your organization is aware of all potential billing opportunities to maximize revenue and sustain integrated care.
Changes to the updated worksheets include:
• Updated CPT codes
• States with services billable by peer support specialists
• Updates to same-day billing allowances
• New states with telemedicine codes
• SBIRT Codes
• Medicare obesity and tobacco counseling codes

CPT and diagnostic codes are consistent across the country; however, state Medicaid programs determine the types of services, codes, and individuals credentialed to provide services, resulting in unique billing rules and regulations in each state. The worksheets link CPT codes with the state-specific diagnostic codes and associated professional credentials needed to submit a successful, payable claim.

CIHS reviewed source material from the state Medicaid offices to identify billing codes and credential requirements. When the information was not clearly available, CIHS contacted the state authorities directly to receive the source material for the updated codes.

Please note: Information in these worksheets is current as of July 2014. Billing codes may change as states change their Medicaid programs. Please verify the information with your state or local billing authorities if you have questions. Please communicate changes affecting your state’s billing guidelines to CIHS.


Billing tools & resources

The medical billing and coding certification homepage features 65 short, instructional videos, all vetted by professionals in the healthcare field, which cover a wide range of billing and coding topics.

WEBINARS

Billing for Integrated Health Services
Financing integrated healthcare is one of the key challenges encountered by organizations during implementation of services. This webinar featured the state based Interim Billing and Financial Worksheets developed by CIHS. The webinar addresses the core aspects of billing for integrated health services and assist participants in successfully using the worksheets to maximize billing opportunities for integrated health services.

June 12, 2012
Presented by Kathleen Reynolds


June 12, 2012
Presented by Kathleen Reynolds

Recording

Presentation

Transcript

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Phone: 202-684-7457