The AMA’s 2013 CPT procedural code book just arrived in the Vālant offices, after a summer’s worth of anticipation around the hints and murmurs of the coding changes on the way for behavioral healthcare providers. You have probably been thinking “What 2013 CPT code changes apply to my psychiatric practice?” It’s not uncommon for hundreds of coding deletions and new additions to appear from year to year in the official CPT guide; however, when your historic pool of coding options has been represented by a few dozen codes, any changes to the coding guidelines for your specialty of care are a big deal and require your careful review and consideration. For mental health practitioners, 2013 is the year.
Regardless of the size or scope of your practice, or the clinical setting in which you work, you will need to address and adjust the coding of your services in 2013. All behavioral healthcare providers or their administrative staff should obtain a copy of the AMA’s 2013 CPT book and follow the guidelines established for their specialty’s billing needs. As a first step for prescribers, you must become familiar with evaluation and management codes and the requirements inherent in using these codes, outside of the counseling and coordination of care allowance. Prescribers and non-prescribers will need to understand the distinctions in the new definitions of time, and how to determine the correct code if the time spent falls in between the designated descriptions. On the administrative side, we recommend that you make contact with all of your contracted payers immediately to determine their reimbursement rates for these new behavioral health CPT codes. If you are a prescriber, you should confirm at the same time that the inclusion of E&M codes and the reimbursement of E&M codes are part of your contract as a behavioral healthcare provider. If the reimbursement rates for E&M codes were not included in your original contract with a given payer, be certain to request that information as well. Making sure that your payer contracts are up to date is one needed step to address the question “How will 2013 CPT codes affect my psychiatric behavioral health practice?” The new 2013 CPT codes will bring changes that extend beyond the provider’s office.