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Screening: An Overlooked Billing Opportunity

Posted By Jim Broyles, PhD, OPA Director of Professional Affairs, Tuesday, May 22, 2018

At the end of April, I attended OPA’s convention, held annually each spring in the Central Ohio area.  Each time I attend, I am reminded of one of the greatest benefits of the event: opportunities for networking.  The experience of networking offers many benefits to psychologists, such as the chance to identify resources, get new ideas for our professional work, share our expertise, or just connect a face to a name.  Few other features of our association give these advantages. 

For example, at one point I was part of a discussion involving psychological services and billing codes.  As is often the case, the conversation began to focus on which services were reimbursed by insurance companies (a topic of discussions I am frequently involved in).  One of my colleagues reminded me that a separate billing for use of screening instruments was allowed by most insurance companies.  I realized that many psychologist, especially folks in private practice, were unaware of or taking advantage of this.  My next idea was that I need to make sure I am passing this information on to OPA members.

My hope is that more psychologists are becoming aware of the importance of measuring and documenting the effectiveness of their work through outcome measures, particularly those who are practicing psychotherapists.  The use of screening instruments can help accomplish this task.  Screening instruments such as Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder 7 (GAD-7), Alcohol Use Disorders Identification Test (AUDIT-C), are commonly used to detect the presence of symptoms and can be used pre, during, and post intervention.  While insurance companies vary on how frequently the use of these measures can be reimbursed, most provide some reimbursement for screening procedures when billed along with initial assessment or psychotherapy codes.  

As a result of requirements created by the Affordable Care Act, CPT Code 96127 was created in 2015.  Defined as brief emotional/behavioral assessment, with scoring and documentation, per standardized instrument, this code may be billed along with an initial assessment or psychotherapy code for each instrument administered.  Though in many cases the reimbursement rates are nominal, regular use of this procedure can create some added income for many practitioners.  Doing so also provides an incentive for clinicians to begin outcome measurement for their work.  For those of you who regularly use screening or brief assessment instruments, I encourage you to remember to bill CPT 96127 along with your regularly used code(s).  For those of you who do not make regular use of screening, I encourage you to start.  As always please reach out to me (jbroyles@ohpsych.org) with questions and comments.

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