Wiki Mental Health Assessment

Hello,

Is someone able to clarify if a patient has to be present for a mental health assessment to be completed (state of Oregon)? We have a new provider to our facility (FQHC) who has some of her previous clients from her private practice transferring with her to be seen under our facility. The provider states she already has assessments on file for these patients and is wondering if she can just "transfer" the assessment and bill or if she needs to bring each client in for an appointment to re-evaluate and update their assessment plan.

Thank you,

Lea

we are running into this same question.. We are also a large FQHC and We have hired a new MD that is bringing a large number of patients with them..
We are trying to figure out the best route to go.. We are leaning towards requiring re-evaluations 90792 for their first appointments because they are establishing care with our practice.. if they need new referrals for therapy/authorizations done to make sure all of our requirements are met that may not have been at the previous practice.

I also had an issue with one of our BH payers before that would not pay an established patient EM code when their PCP was seeing them for their anxiety because they did not have an initial evaluation claim on file..
But that is the grey area..
Are they going to register the initial evaluation that is on file with the provider but under the previous group/tax ID?
Because that could essentially cause payment or denial if that makes sense. Payment for established patient codes if they register it. but they could also deny as a exceeding limitations etc.. I am not sure if my logic even makes sense but just figured it would not hurt to respond and get someone else's perspective!

I have a question if anyone has input ...
FQHC billing for Behavioral Health visit with students in a local school. If an FQHC Provider visits a school to Provide BH Services for Students. Assuming the Provider and the FQHC site are both credentialed with Medicaid.
Can you bill Medicaid correctly with the FQHC site NPI in Line 32a and the address of the school in in line 32? Similar to a the billing for a Provider visiting a Pt in a Nursing home?
Would you use Place of Service as 50 FQHC or 03 School?

SBDuenas said:

I have a question if anyone has input ...
FQHC billing for Behavioral Health visit with students in a local school. If an FQHC Provider visits a school to Provide BH Services for Students. Assuming the Provider and the FQHC site are both credentialed with Medicaid.
Can you bill Medicaid correctly with the FQHC site NPI in Line 32a and the address of the school in in line 32? Similar to a the billing for a Provider visiting a Pt in a Nursing home?
Would you use Place of Service as 50 FQHC or 03 School?

Click to expand...

we have a clinic at our local high school for medical visits but the clinic has its own site NPI because it is considered a permanent site so this may be a bit different. We have a few of our pediatric CRNPs/PAs that go and see patients at the clinic we use our Peds office medical director as the supervising provider. we use the Highschool clinic NPI in box 32a and the school clinic address in box 32 when billing a Medicaid/MCO using POS 50.

We also have Mobile Occupational Therapy and Speech Therapy. They go around to local HeadStart/preschool programs to provide therapy services. Since these are considered mobile sites, they do not need their own location NPI. for these visits we bill under our Pediatric Developmental office NPI in box 32a and office address in box 32., with POS 50 for the Medicaid/MCO insurances and POS 11 to the commercial plans. My supervisor is the FQHC requirement expert so i am not exactly sure what the ruling behind this and im sure there was more that went into the process that i am not aware of... But just figured i could give you a few examples of how we bill..