Saturday, October 04, 2008

Medicare & Medicaid listen up: mental health issues need to be integrated w/ primary care: FUND THE HEALTH & BEHAVIOR CPT CODES

Psychologists who try to work w/ the Primary Care Provider---via telephoning, writing letters---all time consuming things----thus keeping the primary care provider on track in terms of mental health issues which are impacting general health----have only one way to be paid, and that is associated with the H & B CPT codes (Health & Behavior codes) which the American Psychological Association put into play for psychologists January 1, 2002.

As per CIGNA Government Services which oversees Medicare authorization and payment in NC; TN; ID, the 96152 series of the H & B codes are paid only under these conditions:

1. the services must have as a 'place of service' an 'office', code '11'
2. the services must have a referring physicians NPI, a physician associated w/ the patient (nation-wide data base of NPI's is here:

NC Medicaid will not pay for H & B codes.

Specifically, there needs to be allowance for the payment of the H & B codes as associated w/ other 'places or service', specifically, 'the home', code '12' as well as 'group home', code, '14.'

The World Health Organization is advocating that mental health care be better integrated into primary care. What better way to make this happen than to PAY the mental health practitioner for providing these services, linking primary care to mental health care?


New Report Calls For Mental Health To Be Better Integrated Into Primary Care

"The World Health Organization (WHO) and The World Organization of Family Doctors (Wonca) today released a joint report that aims to offer help to hundreds of millions of people who are affected by mental disorders but cannot receive the care and treatment they need.

The report "Integrating mental health in primary care - a global perspective" shows through detailed examples of best practices from 12 nations that, even though the current provision of mental health in primary care is still globally insufficient and unsatisfactory, integration can be successfully achieved in a variety of socio-economic contexts. ....

Though mental disorders represent 13% of the total burden of disease, the gap between the number of people affected and the number receiving care and treatment, even for severe conditions, remains enormous. Data presented in the report show that up to 75% to 86% of people with severe mental disorders in low- and middle-income countries, and 30% to 50% in high-income countries, had received no treatment in the prior 12 months. "


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