Welcome to my blog, a place to explore and learn about the experience of running a psychiatric practice. I post about things that I find useful to know or think about. So, enjoy, and let me know what you think.

Sunday, January 6, 2013

And How Does That Make You Feel?

We've been through a lot of E/M coding together. Figured out how to do some of it. Fumpfed other parts.

But tell me, how do you really feel about the new system?

I hate it, myself, but what I'm really having trouble with is why it exists. Saying that the only way Psychiatry can have parity with Medicine is by billing the same way is like saying the only way Psychiatry can have parity with Medicine is if psychiatrists listen to patients' hearts and lungs and bellies like internists.
It doesn't follow. It's different work.

I'm running on the assumption that someone, somewhere, is making money off this. But I don't know who or where. Or, for that matter, how. I guess the insurance companies will be reimbursing less, because not every session can be a 99215. But the insurance companies are always finding ways to reimburse less. I don't think they're the prime movers, in this case.

I'd be happy to hear people's thoughts about the topic.

And please link over to a poll on Shrink Wrap about the new coding system.


  1. I'm just sick over the whole thing. I've spent hours trying to learn it and now am trying to explain to patients what to expect even though I don't what to expect. I do psychotherapy with most of my patients and most of those are on meds, and some are complex cases. I wish I was another 10 years older and I would retire, maybe. I love the work, and most of the time my patients do well with me. This is such a shame. I am going off Medicare and all panels, so that will help a bit with my fears of being audited. I was audited by Medicare about 10 years ago and it was awful. The patient was very complex with a dissociative disorder and they said I saw him too much and of course my documentation didn't satisfy them. I've been looking for comments from other psychiatrists about this new coding system, but there doesn't seem to much out there so far. Thanks for listening!

  2. You're echoing my feelings. I don't take any insurance, but I still want to allow my patients to be reimbursed as much as possible. Shrink Wrap is writing a lot about it, so you might check out that blog, too.

  3. I want to hear about Laura's audit. I've never heard of a private practice doc being audited.
    The Medicare fees just released for 2013 are remarkably higher. It's the second release of the "final 2013 physician fees." I calculated that the non-par limiting rates are 65% higher if one bills a 60 minute session (53 minutes) + 99212 (very little required documentation) compared to 90807. Seems too good to be true.

    Here, or email me at Shrinkrapblog at g mail dot com.

    Psychpractice, no discussion of the NY SAFE Act? It has me ranting on all 3 of my blogs. Am I over-reacting? What does the New York crew say?

    And we're Shrink Rap. if you google 'wrap' you get food storage devices.