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FAQ on new psychiatry CPT codes

OPPA/APA members can review the new coding information, which includes a list of the new codes, a crosswalk of 2012 CPT codes to their replacement 2013 CPT codes, and a brief description of the major changes here. APA has also prepared a list of FAQs to provide general information about the coming changes. The page will be updated as new questions are raised and information released.

Following is one such frequently asked question:

Q: I practice at a community mental health center where my billing department has told me that I cannot use E/M codes because "it's not allowed" and because no insurance company, including Medicare, will reimburse for them. I have never understood this and am now wondering whether we will suddenly be able to use E/M codes in 2013 or whether we'll have trouble getting paid for anything.

A: The CMHC where you work may, for whatever reasons, choose not to bill using E/M codes, and they may have contracts with some insurers that limit them to the codes in the Psychiatry section of CPT.  However, Medicare has no stricture against reimbursing psychiatrists for providing E/M services and under Parity, no insurance company should refuse to reimburse psychiatrists when they provide E/M services.  Under the new coding framework psychiatrists will have to use E/M codes for the evaluation and management services they provide.

For more Q and A's, click HERE.

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