Why aren't psych testing report writing hours reimbursed?

[Rivi]

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Hello everyone,

Correct me if I am wrong here, but it seems that the majority of managed care companies don't reimburse the HOURS that we spend writing psych testing reports. In all the settings I have worked, it seemed that the managed care companies provide a general hour number (i.e., 5 hours of testing, 3 for administration and 2 for scoring) but don't reimburse the report writing aspect.

Also, is the interview that we do for testing reimbursed? For example, if I interview someone for an hour, then do the testing session, is that interview included or separate?

If so, WHY ARE WE ALLOWING THIS? It seems basically like we are working for free on this.

 

[futureapppsy2]

Report writing in general isn't reimbursed. Of course, you could argue that psychometric scoring and interpretation is more complex and time consuming than other kinds of report writing, but the idea that the time spent writing and interpreting test results is "rolled into" the reimbursement for the testing/assessment is not limited to just psychology.

As for the interview question, I'm not sure. I want to say that there is a separate CPT code for that, but don't quote me on it.

 

[AcronymAllergy]

I believe there should be a separate code for the interview, yes; at least based on the limited experience I have. I think for a neuropsych, for example, there's the neurobehavioral status exam, or something like that.

 

[MBellows]

I believe there should be a separate code for the interview, yes; at least based on the limited experience I have. I think for a neuropsych, for example, there's the neurobehavioral status exam, or something like that.

http://psychcentral.com/lib/2007/cpt-codes-for-psychology-services/

I want to say that our office uses 90801 as a standard for interview, even for most neuropsych. But I may be mistaken.

 

[IT514]

The clinical interview is reimbursed.

Report writing is rolled into a 9611something code, which includes scoring and interpretation. I'm not sure how well this is reimbursed. I'm an intern at a VA, so I'm a bit protected from that stuff.

 

[Justanothergrad]

It's a per service billing and not time-based. Therapies have a timelimit. Assessments do not. It would be impossible to verify the time spent anyway and would open the door to fraud imho. It's way easier to say assess and provide results at a given rate than to try and create a sliding scale with all the factors that might play a role.

http://psychcentral.com/lib/2007/cpt-codes-for-psychology-services/

I want to say that our office uses 90801 as a standard for interview, even for most neuropsych. But I may be mistaken.

That was the code I used as well.

 

[bcliff]

Our office uses 90791 for initial consult, then 96101 for all testing. Our own policy is that we double the time the publisher says it takes to administer the testing and use that for billing purposes (which is pretty standard I think). Insurance providers that don't require preauth don't seem to have a problem with this, and then others that do (medicaid) will butcher our authorization and deny half of the testing and then give us significantly less time then we requested for certain assessments, not to mention their reimbursement rate is less than a third of our regular rate for testing. We're the only PP in the area that accepts medicaid, so it's a good source of clients and revenue to have, but it's not where we make the bulk of our money. Seems like testing is a crap shoot, but there is some money to be made with private pay clients and court ordered assessments. We do a few substance abuse/psychosexual assessments each week and those clients pay between $500-$600 up front the day the testing is administered.

 

[Therapist4Chnge]

Take this w. a grain of salt bc I use a billing service that makes sure I don't screw things up This is for my neuropsych evals:

90791: Initial Eval (typically an hour interview done by me)
96119: Testing by a Tech (includes administration & scoring)
96118: Interpretation and Report Writing (done by me)

This is done only after confirmation of medical necessity, verification of insurance, and pre-auth by insurance (if applicable). The actual billing is done across multiple days bc of availability of providers. There is also a feedback session, though I don't know the billing code off hand. Included w. the codes is time for record review, integration of the test data with other findings (imaging, evals from other providers, etc). I'm only booked out 2-3 weeks, but it'll probably be 2-3 months if things keep going. I'm currently reviewing my #'s to see what kind of mix I can sustain between private insurance, Medicare, cash pay, etc. I don't take Medicaid for neuropsych evals, and I'm limiting how many cases I'll see in a month, as I want to keep banker's hours. 😉

*edit*

90791 is the "update" to 90801.