Introduction
The field of behavioral health is undergoing significant changes in the way services are delivered and reimbursed. As we move into 2024, several key updates will impact how behavioral health providers bill for their services. In this article, we will explore the most important behavioral health billing updates planned for 2024, focusing on both Medicare and commercial payers.
Behavioral Health Billing Updates: For Medicare
1. Direct Billing by MFTs and MHCs
One of the most significant changes for Medicare in 2024 is the ability of marriage and family therapists (MFTs) and mental health counselors (MHCs) to directly bill for their services. This change, which takes effect on January 1, 2024, is expected to increase access to behavioral health services for Medicare beneficiaries who may not have otherwise been able to afford them.
2. Telehealth Payment
Telehealth services furnished to individuals in their homes will be paid at the non-facility Physician Fee Schedule (PFS) rate in 2024. This change aligns with telehealth-related flexibilities that were extended through the Consolidated Appropriations Act, 2023. This update is significant as it promotes greater access to behavioral health services, particularly for individuals in rural or underserved areas.
3. Extension of Telehealth Flexibilities for RHCs and FQHCs
In an effort to maintain access to behavioral health services in rural and underserved areas, payment for telehealth services furnished in Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) will be extended through December 31, 2024.
4. Delay of In-Person Requirements for RHCs and FQHCs
The in-person requirements for mental health visits furnished by RHCs and FQHCs will be delayed in 2024. This change provides additional flexibility for these providers and ensures that patients can continue to access necessary services.
Behavioral Health Billing Updates: For Commercial Payers
1. Adoption of New CPT Codes
Many private payers are expected to adopt new CPT codes for behavioral health services in 2024. These new codes are more specific and accurate than the codes currently used, which should lead to improved claims processing and reimbursement.
2. Increased Focus on Value-Based Care
There is a growing trend among payers to move towards value-based care models for behavioral health services. This means that providers will be rewarded for achieving positive outcomes for their patients, rather than simply for the volume of services they provide. This shift is expected to continue in 2024 and beyond.
Preparing for Behavioral Health Billing Updates
With several significant billing updates planned for 2024, it is important for behavioral health providers to stay informed and prepare accordingly. Here are some tips:
- Review the new CPT codes: Familiarize yourself with the new CPT codes for behavioral health services and ensure your billing system is updated to accept them.
- Update your billing and coding policies: Make sure your billing and coding policies are up-to-date to reflect the changes in Medicare and private payer rules.
- Get training: Consider attending training sessions or webinars on the new billing updates to ensure you are fully prepared.
- Consult with your billing and coding specialists: Your billing and coding specialists can provide you with personalized guidance on how to comply with the new rules and maximize your reimbursement.
By staying informed and taking the necessary steps to prepare, behavioral health providers can ensure a smooth transition to the new billing rules and continue to provide high-quality care to their patients.
Medisys: Your Reliable Partner in Behavioral Health Billing
At Medisys, we understand the unique challenges faced by behavioral health providers when it comes to medical billing. Our team of experts is dedicated to helping you navigate the complexities of ever-changing regulations and ensure accurate and efficient claims processing. Here’s how Medisys can support your behavioral health practice:
- Compliance Expertise: We stay up-to-date on the latest Medicare and private payer billing guidelines for behavioral health services, ensuring your claims are submitted correctly and maximize your reimbursement.
- Coding Accuracy: Our team of certified medical coders uses the most recent CPT and ICD-10 codes, ensuring accurate coding that minimizes claim denials and delays.
- Telehealth Billing Expertise: We understand the nuances of telehealth billing for behavioral health services, helping you navigate the specific requirements and maximize your revenue.
- Denial Management: We proactively identify and address potential claim denials, minimizing lost revenue and ensuring you receive the reimbursement you deserve.
- Dedicated Account Management: You’ll have a dedicated account manager who understands your practice’s needs and provides personalized support throughout the billing process.
Medisys is more than just a medical billing company. We are your partner in success, committed to helping your behavioral health practice thrive. Contact us at 888-720-8884 / info@medisysdata.com to know more about how we can help you achieve financial stability.
References:
CMS Fact Sheet: Calendar Year (CY) 2024 Medicare Physician Fee Schedule Final Rule
APA Services: 2024 Physician Fee Schedule final rule released
