Telehealth and Behavioral Health: What you Need to Know to Get Paid and Stay Compliant

• Why you must know your current state Medicare, Medicaid, and commercial payor Telehealth rules
• How to avoid denials caused by incomplete Telehealth documentation
• The criteria for prescribing controlled medications using telemedicine
• Pointers for phone-only visits and the visits you cannot bill
• Modifiers are critical, and every payor may have their own
• The most common Telehealth coding errors and how to avoid them
• Tips for coding telehealth for commercial payers and Medicaid

2025 Incident-To and Other Updated Guidelines You Need to Follow

• Key distinctions to remember when billing Incident-To and deciding which NPI number to bill under
• How to document Incident-To services to properly link NPP services
• Updated guidance for utilizing Split/Shared coding for E/M visits
• How G2211 pertains to behavioral health and pointers for documenting
• The modification made to Family Psychotherapy (90849) coding

2024 CPT Updates and Beyond

• How to follow the revised time definitions and clarified MDM guidelines for E/M coding
• The new time requirements for Nursing Facility Care codes 99306, 99308, and 99418
• Accurate use of MDM for Split / Shared Visits and which provider should report the E/M
• The many dos and don’ts of reporting Multiple E/M on the same day of service
• The codes you no can longer report for Hospital Inpatient, Observation Care, Admission and Discharge Services
• When you can and cannot report the new G2211 and its potential impact on reimbursement

Billing and Coding for Naloxone, Partial Hospitalization Programs, Ketamine, and TMS Treatments

• What you need to know about payers and coding Naloxone Treatments
• Process options for setting up Medication-Assisted Treatment programs, and how to select the best for your practice
• Which PHP services are bundled, and the documentation needed for PHP services
• How to avoid key compliance issues in coding for Ketamine administration
• To correctly break down TMS coding and avoid the typical confusion
• The 4 new T-codes created for chronic pain management

Coding for “Incident-To” Services

• What you need to look for in private payor contracts and guidelines
• To not bill Incident-To in ways that increase your audit risk
• The potential impact on reimbursement that can be seen with proper billing of Incident-To
• To avoid issues with Incident-To Medicare guidelines and documentation requirements
• Medicare Split/Shared services are not treated the same as Incident-To services
• Who’s NPI number you should bill under and when

Psychiatry Coding and Hot Topics

• Coding for psychotherapy with and without E/M
• Guideline clarifications issued for psychotherapy coding and documentation
• How to correctly code and document 90791 and 90792 and the codes you cannot bill with these evaluations
• Proper use of the Interactive Complexity add-on code, the documentation required, and the codes you cannot use with 90785
• Who can bill Psychotherapy for crisis codes 90839 and 90840, and the proper time calculations
• When you should bill for psychiatric records review in addition to therapy
• To prevent common reimbursement issues when using 90846 and other Family and Group Psychotherapy codes
• The proper way to document new ICD-10 dementia diagnosis codes

Office/Outpatient E/M Coding Updates: Maximize Reimbursement and Remain Compliant

• The documentation payers require to support your selected E/M level
• Ways to document efficiently while documenting correctly
• What you can take credit for in calculating MDM
• The activities you can include when using Time to level E/M
• Exactly when and how you’re allowed to use prolonged services code 99417
• Documentation details needed to avoid denials for E/M with psychotherapy

Inpatient E/M Coding

• Gain and maintain command of coding for Inpatient E/M services
• When you can separately bill interpretation of test results
• How to confirm details of key guideline revisions for Nursing Facility, Domiciliary, Rest Home, and Custodial Care and Home or Residence Services
• To avoid errors and denials when coding for hospital services including emergency department, admission, discharge, and observation services
• When you can separately bill interpretation of test results, and how to get reimbursed for Cognitive Assessment and Care Plan services
• To recognize the codes you cannot use with prolonged services coding

Psychiatry Coding Examples: Putting It All Together

• How to apply current coding rules to clinical case examples in both outpatient and inpatient settings using both E/M and psychiatric section codes
• The multiple ways proper documentation can protect you
• How reimbursement can be impacted by using E/M vs initial evaluation, and MDM vs Time
• When you can use Interactive Complexity and the documentation you’ll need
• Cases detailing how to code Emergency Department, and Hospital Inpatient and Observation services to avoid compliance issues

Audits in Psychiatry: Avoid the Pitfalls and Keep Your Money!

• Why audits in psychiatry have been on the rise
• How to avoid becoming a target for an audit
• The ways compliance can help you withstand and avoid audits
• How to create and implement a successful compliance program
• The compliance elements the Feds find important
• The most common coding errors you need to prevent
• What to do if you get a records request
• The steps to take if you receive a payor request for take-backs

25 Self-Assessment Q&As with 2 Self-Assessment Credits