Birthday Rule Coordination of Benefits for Therapy Claims
Birthday rule coordination of benefits is how insurers decide which parent’s plan pays first when a child is covered under both parents’ health plans. A wrong guess mea
90791 vs 90792: Who Can Bill Each Evaluation Code
The 90791 vs 90792 who can bill question comes down to one thing: whether the evaluation includes medical services. CPT 90791 is a psychiatric diagnostic evaluation without medical
Clean Claim in Therapy Billing: 6 Easy, Essential Checks
A clean claim in therapy billing gets paid faster. Run these six checks before you submit, and learn how payers, Medicare and states differ.
Allowed Amount in Therapy Billing: 5 Easy, Essential Checks
The allowed amount is the most a plan pays for a covered visit. Learn 5 facts that explain why you are paid less than you bill, and what to do about it.
Coinsurance vs Copay vs Deductible: 3 Easy Differences
Coinsurance vs copay vs deductible: learn the 3 differences, how each shows on an EOB, and how to explain what a client owes before the first visit.
Balance Billing for Therapists: 5 Easy, Essential Rules
Balance billing means billing a client for the gap between your fee and the allowed amount. Learn 5 rules on when it is allowed, and when it is not.
90833 Billing Errors: 5 Fixes for Psychiatric Add-On Codes
90833 billing errors happen when a psychiatric practice bills a psychotherapy add-on code with an evaluation and management (E/M) visit. The add-on codes are 90833, 90836 and 90838
Illinois CPT 96127 Modifier: U1 and U2 Explained
The Illinois CPT 96127 modifier rule is now in effect: Illinois requires a modifier on CPT 96127 claims. The Illinois Department of Healthcare and Family Services (HFS) says claims
CPT 96127: Billing Brief Emotional and Behavioral Assessments
CPT 96127 is the code for a brief emotional or behavioral assessment with scoring and documentation, per standardized instrument. The American Medical Association’s behaviora
CPT 90785 Interactive Complexity: Billing Rules and Documentation
CPT 90785 is the interactive complexity add-on code. You report it with certain psychiatric services when communication problems make the visit harder to deliver. It is never bille