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CPT Codes for Testing Services Change in January 2019

Posted By Jim Broyles, PhD, OPA Director of Professional Affairs, Tuesday, December 4, 2018

No doubt by this time many OPA members are aware that the CPT Codes commonly used to bill testing services are changing. This means that those testing codes familiar to us can only be used to bill testing services to insurance companies until December 31, 2018. On January 1, 2019, the new codes will be required. The newer codes are more complex and take into account a number of factors the old codes do not capture, and are able to more accurately describe the work required when multiple hours of technical and professional services are performed. In many ways the new coding structure will more greatly benefit psychologists for services provided in this area. However, due to their complex nature, there is not a simple crosswalk from the old codes to the new. It is therefore imperative that psychologist get training on the use of the new codes to ensure their correct use as well as to be fully reimbursed for all their work. 

APA has provided resources to educate psychologists on the use of the new codes. Presently, the most accessible is a webinar available on YouTube entitled “Getting Reimbursed: Testing Code Changes are Here” by Antonio Puente, PhD and Neil H. Pliskin, PhD. 

View webinar here: https://www.youtube.com/watch?v=Q1kAZEgih2w

This 1 hour webinar gives a good overview of the use of the new codes and should help any psychologist feel more prepared for the coming change.

OPA members should also stay aware of the timing of their billing. While your APA and OPA leadership has been working to ensure that insurance companies are aware of and ready for the coming changes, unfortunately there is no guarantee that all individual companies will be fully prepared. Typically, big changes such as this require them to make significant systems changes. History has demonstrated that sometimes these changes are executed smoothly but sometimes not. Billers of psychological testing services will maximize their chances of avoiding confusion and unnecessary reimbursement delays by paying very care attention to the timing of their billing. All psychological testing services rendered in 2018 should be billed by December 31, 2018, so that all billing sent in 2019 will be for testing service provided January 1, 2019 and beyond. This approach may circumvent some issues with readiness the respective insurance companies may experience.

Please feel free to email me with questions or for additional resources.

Tags:  cpt codes 

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APAPO Survey on the valuation of CPT codes

Posted By Jim Broyles, PhD, OPA Director of Professional Affairs, Wednesday, May 24, 2017

You may be receiving a very important survey soon from the American Psychological Association Practice Organization. The surveys will be emailed to APAPO members, and will be gathering vital information regarding the valuation of Current Procedural Terminology (CPT) codes commonly used by psychologists, which directly affects reimbursement rates set by all insurance companies. The survey is developed by the American Medical Association /Specialty Society Relative Value Scale Update Committee (RUC). Click here to view an article from a recent APAPO Practice Update which explains the survey. It is very important for you, if you are a member of APAPO, to be on the lookout for the survey and to set aside the 2 hours it may take to complete it. If you have questions feel free to contact me.

On a related note, I received many positive comments about my last communication with OPA members regarding the letters from Change Healthcare. This group contacted psychologists regarding their billing practices and use of certain CPT codes. In that communication, I outlined concerns expressed by APAPO and OPA to Change, as well as gave specific recommendations on how to respond to their requests. During our recent OPA Convention and through email, many of you pointed out how helpful this information was. I feel compelled in response to point out to everyone that the guidance from that communication would have been impossible if not for the considerable efforts of APAPO’s office of Legal and Regulatory Affairs, specifically attorneys Alan Nessman and Connie Galietti. Both expended considerable time and effort communicating with the organizations in question, drawing on their considerable legal experience and expertise, to produce the guidance you received. This is only a small example of the ongoing advocacy and support Ohio psychologists receive from APAPO. Many psychologists today remain unaware of the vital support they receive from APAPO, and how our more local advocacy efforts are dependent on their help. I urge all Ohio psychologists to be mindful of this when making a decision on whether to become a member of this organization.

Tags:  apapo  cpt codes  survey 

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