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Medicare Psychiatric Reduction

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  • DTru
    For Mental Health billers: I have just discovered the 20% Psychiatric Reduction from Medicare for an office in Kansas. Arizona does not have such a reduction!
    Message 1 of 4 , Aug 14, 2012
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      For Mental Health billers:

      I have just discovered the 20% Psychiatric Reduction from Medicare
      for an office in Kansas. Arizona does not have such a reduction! I
      do not understand why Medicare, a Federal Program, reduces their
      payment schedule in one part of the country and not in another. I am
      also amazed that they are doing this with claims with DXs between 290
      and 319. That pretty much covers all mental disorders.
      How do you, the practitioners on this list, handle such a thing? Do
      you find other DX codes or procedure codes that are still
      appropriate to the situation, or do you just "take it on the chin"?

      One doctor tells me that she will discuss meds with the patient and
      then bill the code 90862.

      I also see that the reduction will be phased out by 2014.

      Frankly, I think this is one of the craziest things I have heard from
      Medicare, and that is saying a lot!

      Any input will be Greatly appreciated!

      Many Thanks,

      Deb


      Tru Medical Billing,
      at your service

      Deb Tru
      602-525-9888
      Fx: 866-582-6936
      www.tmedbilling.com

      [Non-text portions of this message have been removed]
    • Melinda
      If you see on your Medicare EOB, it puts the psych reduction to PR122, which can be billed to the patient (PR=Pt resp). We bill it to the secondary insurance.
      Message 2 of 4 , Sep 6, 2012
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        If you see on your Medicare EOB, it puts the psych reduction to PR122, which can be billed to the patient (PR=Pt resp). We bill it to the secondary insurance.

        Melinda Brown, CMBS
        Ins Biller

        --- In MedicalBillers@yahoogroups.com, DTru <dtru@...> wrote:
        >
        > For Mental Health billers:
        >
        > I have just discovered the 20% Psychiatric Reduction from Medicare
        > for an office in Kansas. Arizona does not have such a reduction! I
        > do not understand why Medicare, a Federal Program, reduces their
        > payment schedule in one part of the country and not in another. I am
        > also amazed that they are doing this with claims with DXs between 290
        > and 319. That pretty much covers all mental disorders.
        > How do you, the practitioners on this list, handle such a thing? Do
        > you find other DX codes or procedure codes that are still
        > appropriate to the situation, or do you just "take it on the chin"?
        >
        > One doctor tells me that she will discuss meds with the patient and
        > then bill the code 90862.
        >
        > I also see that the reduction will be phased out by 2014.
        >
        > Frankly, I think this is one of the craziest things I have heard from
        > Medicare, and that is saying a lot!
        >
        > Any input will be Greatly appreciated!
        >
        > Many Thanks,
        >
        > Deb
        >
        >
        > Tru Medical Billing,
        > at your service
        >
        > Deb Tru
        > 602-525-9888
        > Fx: 866-582-6936
        > www.tmedbilling.com
        >
        > [Non-text portions of this message have been removed]
        >
      • DTru
        Thanks Melinda, I guess the patient with no secondary gets to pay the difference. ... Many Thanks, Deb Tru Medical Billing, at your service Deb Tru
        Message 3 of 4 , Sep 13, 2012
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          Thanks Melinda, I guess the patient with no
          secondary gets to pay the difference.


          At 10:30 AM 9/6/2012, you wrote:
          >
          >
          >If you see on your Medicare EOB, it puts the
          >psych reduction to PR122, which can be billed to
          >the patient (PR=Pt resp). We bill it to the secondary insurance.
          >
          >Melinda Brown, CMBS
          >Ins Biller
          >
          >--- In
          ><mailto:MedicalBillers%40yahoogroups.com>MedicalBillers@yahoogroups.com,
          >DTru <dtru@...> wrote:
          > >
          > > For Mental Health billers:
          > >
          > > I have just discovered the 20% Psychiatric Reduction from Medicare
          > > for an office in Kansas. Arizona does not have such a reduction! I
          > > do not understand why Medicare, a Federal Program, reduces their
          > > payment schedule in one part of the country and not in another. I am
          > > also amazed that they are doing this with claims with DXs between 290
          > > and 319. That pretty much covers all mental disorders.
          > > How do you, the practitioners on this list, handle such a thing? Do
          > > you find other DX codes or procedure codes that are still
          > > appropriate to the situation, or do you just "take it on the chin"?
          > >
          > > One doctor tells me that she will discuss meds with the patient and
          > > then bill the code 90862.
          > >
          > > I also see that the reduction will be phased out by 2014.
          > >
          > > Frankly, I think this is one of the craziest things I have heard from
          > > Medicare, and that is saying a lot!
          > >
          > > Any input will be Greatly appreciated!
          > >
          > > Many Thanks,
          > >
          > > Deb
          > >
          > >
          > > Tru Medical Billing,
          > > at your service
          > >
          > > Deb Tru
          > > 602-525-9888
          > > Fx: 866-582-6936
          > > www.tmedbilling.com
          > >
          > > [Non-text portions of this message have been removed]
          > >
          >
          >



          Many Thanks,

          Deb


          Tru Medical Billing,
          at your service

          Deb Tru
          602-525-9888
          Fx: 866-582-6936
          www.tmedbilling.com

          [Non-text portions of this message have been removed]
        • Melinda
          Correct.
          Message 4 of 4 , Sep 14, 2012
          • 0 Attachment
            Correct.

            --- In MedicalBillers@yahoogroups.com, DTru <dtru@...> wrote:
            >
            > Thanks Melinda, I guess the patient with no
            > secondary gets to pay the difference.
            >
            >
            > At 10:30 AM 9/6/2012, you wrote:
            > >
            > >
            > >If you see on your Medicare EOB, it puts the
            > >psych reduction to PR122, which can be billed to
            > >the patient (PR=Pt resp). We bill it to the secondary insurance.
            > >
            > >Melinda Brown, CMBS
            > >Ins Biller
            > >
            > >--- In
            > ><mailto:MedicalBillers%40yahoogroups.com>MedicalBillers@yahoogroups.com,
            > >DTru <dtru@> wrote:
            > > >
            > > > For Mental Health billers:
            > > >
            > > > I have just discovered the 20% Psychiatric Reduction from Medicare
            > > > for an office in Kansas. Arizona does not have such a reduction! I
            > > > do not understand why Medicare, a Federal Program, reduces their
            > > > payment schedule in one part of the country and not in another. I am
            > > > also amazed that they are doing this with claims with DXs between 290
            > > > and 319. That pretty much covers all mental disorders.
            > > > How do you, the practitioners on this list, handle such a thing? Do
            > > > you find other DX codes or procedure codes that are still
            > > > appropriate to the situation, or do you just "take it on the chin"?
            > > >
            > > > One doctor tells me that she will discuss meds with the patient and
            > > > then bill the code 90862.
            > > >
            > > > I also see that the reduction will be phased out by 2014.
            > > >
            > > > Frankly, I think this is one of the craziest things I have heard from
            > > > Medicare, and that is saying a lot!
            > > >
            > > > Any input will be Greatly appreciated!
            > > >
            > > > Many Thanks,
            > > >
            > > > Deb
            > > >
            > > >
            > > > Tru Medical Billing,
            > > > at your service
            > > >
            > > > Deb Tru
            > > > 602-525-9888
            > > > Fx: 866-582-6936
            > > > www.tmedbilling.com
            > > >
            > > > [Non-text portions of this message have been removed]
            > > >
            > >
            > >
            >
            >
            >
            > Many Thanks,
            >
            > Deb
            >
            >
            > Tru Medical Billing,
            > at your service
            >
            > Deb Tru
            > 602-525-9888
            > Fx: 866-582-6936
            > www.tmedbilling.com
            >
            > [Non-text portions of this message have been removed]
            >
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