Category: Billing
Understanding Billing Codes
CPT Codes
CPT Codes are used for individual providers, such as those in private practice. CPT Codes are billed on the CMS-1500 Form, also called the “HCFA.” Even if you do not accept insurance, if a client has a PPO insurance plan, they may receive some reimbursement for services. For clients with PPO insurance, you may print a “superbill” which has the CPT code on the form. You may also provide a patient with a pre-printed CMS-1500 form, which are available on Amazon.
Here are some examples of CPT Codes, with sample rates:
CPT CODE | DESCRIPTION | BILLING AMOUNT |
---|---|---|
0 | none | $0 |
90792 | Psychiatric Diagnostic Evaluation (with Medical Services) | $300 |
90833 | ADD ON-30 Min Psychotherapy | $50 |
90837 | Psychotherapy 60 min (53+ min) | $180 |
90838 | ADD ON-60 Min Psychotherapy | $100 |
90839 | Psychotherapy (Crisis) | $340 |
97813 | Acupuncture with Electrical Stimulation – 15 Minutes | $50 |
97814 | Acupuncture with Electrical Stimulation – Additional 15 Minutes | $50 |
99205 | Psychiatry 60 min Follow-Up E&M | $300 |
99215 | Psychiatry 30 min Follow-Up E&M | $150 |
G0434 | Drug Testing, EtG/EtS Urine Alcohol | $85 |
G0434 | Drug Testing, Urine Drug Screen (DSC6309) | $25 |
HCPCS Codes
Facility codes, also known as HCPCS Codes, are used by hospitals, intensive outpatient treatment centers, and other facilities. These codes are billed on the UB-04 form. UB-04 Forms are also available on Amazon. Most private practitioners will not need to use the UB-04 or do any facility billing.
20 Questions To Ask Yourself When Starting a Business
Ask yourself these 20 questions to make sure you’re thinking about the right key business decisions:
1. Why am I starting a business?
2. What kind of business do I want?
3. Who is my ideal customer?
4. What products or services will my business provide?
5. Am I prepared to spend the time and money needed to get my business started?
6. What differentiates my business idea and the products or services I will provide from others in the market?
7. Where will my business be located?
8. How many employees will I need?
9. What types of suppliers do I need?
10. How much money do I need to get started?
11. Will I need to get a loan?
12. How soon will it take before my products or services are available?
13. How long do I have until I start making a profit?
14. Who is my competition?
15. How will I price my product compared to my competition?
16. How will I set up the legal structure of my business?
17. What taxes do I need to pay?
18. What kind of insurance do I need?
19. How will I manage my business?
20. How will I advertise my business?
Having a game plan that answers these questions will put you ahead of the pack. This exercise may also bring up questions about whether private practice is the right choice for you. Not everyone is cut out to work for themselves.
Private practice requires you to tolerate a certain amount of risk. If this risk/reward equation is not exciting to you, a more stable form of employment may be a consideration.
Welcome
This is the first post of the Practice Private Blog. This is a site exploring all elements of running a mental health practice.
You must be logged in to post a comment.