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Owing to its interdisciplinary nature – integration of knowledge in the biological, behavioral, psychological, and social sciences relevant to health and illness – Behavior Medicine physicians hardly find time to manage their medical bills filed and reimbursed efficiently.
Alternatively, our Behavior Medicine Billing Advisory – comprising AAPC certified medical coders, who are proficient in generating diverse behavior medicine bills on advanced software such as Lytec, Medic, Misys, Medisoft, NextGen, IDX, etc., and applying specific CPT, ICD-10, & HCPCS; complying with HIPAA privacy norms; and processing the prepared bills with leading private insurance carriers such as United health, Wellpoint, Aetna, Humana, HCSC, Blue Cross Group, and Government sponsored Medicare and Medicaid as well – has been able fill in the void successfully, and ensure greater revenue generation for Behavior Medicine physicians, patient inflow and referrals, and medical efficiency.
Our billing advisory has been able to cater to a majority of Behavior Medicine professionals comprising of psychologists, physicians, and qualified nurses by employing a comprehensive billing and coding approach that covers the whole gamut of behavior medicine procedures including:
A thorough knowledge of the Current Procedural Terminology (CPT) coding system covering the comprehensive health and behavior assessment and intervention of medical services has been pivotal in enabling accurate and refined medical billing on our clients’ behalf. Following list of CPT codes used in coding Behavior Medicine procedures is a valid endorsement of our integrity in compliant coding system:
| CPT Codes | Corresponding Behavior Assessment and Intervention Medical Services |
| 96150 | For initial assessment of the patient to determine the biological, psychological, and social factors affecting the patient’s physical health and any treatment problems |
| 96151 | For re-assessment of the patient to evaluate the patient’s condition and determine the need for further treatment; a re-assessment may be performed by a clinician other than the one who conducted the patient’s initial assessment |
| 96152 | For interventional service provided to an individual to modify the psychological, behavioral, cognitive, and social factors affecting the patient’s physical health and well being |
| 96153 | For interventional service provided to a group; an example is a smoking-cessation program that includes educational information, cognitive-behavioral treatment and social support |
| 96154 | To code interventional service provided to a family with the patient present |
| 96155 | To code interventional service provided to a family without the patient being present |
Coupling a competent coding regimen with timely and accurate modifiers, our Behavior Medicine Billing Advisory has been able to mitigate undesirable delay/denial of its clients’ medical reimbursements. Modifier 22 for Extended Service and Modifier 52 for Reduced Service (where in the provider reduces or eliminates a portion of the service or procedure, which results in a reduction in reimbursement. The reduced service is identified by its CPT code and the addition of the modifier-52) are prime examples of Modifiers adopted in our billing management.
The Behavior Medicine physicians, who lent preference to our billing and coding competencies – complete with accurate charge-capture, intricate procedure coding, electronic filing of claims, patient billing, multi-tiered appeal process, denial elimination initiatives, and compliance standards – have been able to witness simplification of revenue cycle, appreciable increase in collection rates, more patient inflow and referrals, and Increased avenue for medical research and development.
