Description
Analyze reimbursement rates for mental health treatments for psychiatric mental health nurse practitioner in the state of Georgia.
To prepare for this Practicum Journal:
Research reimbursement rates for various treatment modalities.
Compare Nurse Practitioner rates to other provider rates.
Reimbursement Rate Template
Type of
Service
eg. -New office
visit
-Established
office visit
-Inpatient
hospital
-individual
psychotherapy
-group
psychotherapy
(see examples
below)
Psych
diagnoses
evaluation
w/med
services
CPT
code
Private
insurer
reimburse
ment rate
for
PMHNP
Private
insurer
reimburseme
nt rate for
physicians
Medicare
reimburseme
nt rate for
PMHNP
90792
Office/outpatie
nt visit new
99201
Initial hospital
care
99221
Psych
treatment
w/patient 60
minutes
90837
Group
psychotherapy
90853
90791
1
Psychiatric diagnostic evaluation
90837
6
Psychotherapy, 60 minutes with patient and/or family member
90870
1, 5
Electroconvulsive therapy (includes necessary monitoring)
Medicare
reimburseme
nt rate for
physician
As the PMHNP becomes proficient in diagnosing and treating, it is also important to learn how to bill for
your time. The CMS sets up codes to identify the type of service you are providing.
CPT Codes for Psychiatric and Psychological Procedures
Billing
These links might be helpful:
https://www.psychiatry.org/psychiatrists/practice/practice-management/coding-reimbursement-medicareand-medicaid/coding-and-reimbursement
http://www.mb-guide.org/medical-coding-guidelines.html
https://www.cms.gov/apps/physician-fee-schedule/overview.aspx
Purchase answer to see full
attachment
Type of
Service
eg. -New office
visit
-Established
office visit
-Inpatient
hospital
-individual
psychotherapy
-group
psychotherapy
(see examples
below)
Psych
diagnoses
evaluation
w/med
services
CPT
code
Private
insurer
reimburse
ment rate
for
PMHNP
Private
insurer
reimburseme
nt rate for
physicians
Medicare
reimburseme
nt rate for
PMHNP
90792
Office/outpatie
nt visit new
99201
Initial hospital
care
99221
Psych
treatment
w/patient 60
minutes
90837
Group
psychotherapy
90853
90791
1
Psychiatric diagnostic evaluation
90837
6
Psychotherapy, 60 minutes with patient and/or family member
90870
1, 5
Electroconvulsive therapy (includes necessary monitoring)
Medicare
reimburseme
nt rate for
physician
As the PMHNP becomes proficient in diagnosing and treating, it is also important to learn how to bill for
your time. The CMS sets up codes to identify the type of service you are providing.
CPT Codes for Psychiatric and Psychological Procedures
Billing
These links might be helpful:
https://www.psychiatry.org/psychiatrists/practice/practice-management/coding-reimbursement-medicareand-medicaid/coding-and-reimbursement
http://www.mb-guide.org/medical-coding-guidelines.html
https://www.cms.gov/apps/physician-fee-schedule/overview.aspx
Purchase answer to see full
attachment
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