Practice Management Insight

February 2009

A report on events affecting Oklahoma providers

To remove your name from our mailing list, please click here.

Questions or comments? E-mail us at [email-masked] or call 405.286.1674

The Oklahoma Health Care Authority said he would delay modifications to billing codes and changes to rates for Psychotherapy/Counseling and Therapy.  Changes were to take effect March 1, but on February 6, OHCA notified outpatient behavioral health providers that it was delaying the change until April 1.  It said it would re-evaluate the rates “due to provider feedback we've received.”

Some centers saw the originally announced changes as across-the-board rate reductions.

“Last year they gave a raise; this year they took most of it back,” one behavioral health center director said.  “By my calculations, it’s about a 7 percent reduction across the board,” he added.  The director said he arrived at this number by comparing payments received on some existing Individual

Psychotherapy treatment plans and what

MARK YOUR

CALENDAR

February 11

Drug Utilization Review Board Meeting

6:00-8:00pm, OHCA

More Information

February 12

OHCA Board Meeting

1:00-3:00pm, OHCA
More Information

February 13

ASAM with Steve Stewart

Tulsa Marriott Southern Hills

1902 E 71st

Tulsa, OK 74136

Contact: 405.522.8300

Event Information

Online Registration

February 11-13

2nd Annual Combined
Mental Health, Prevention & Substance Abuse Conference
Embassy Suites Norman
Hotel and Convention Center
2501 Conference Drive

Norman, OK 73609

Contact: 405.522.8300
Event Information

Visit the ThinkHealth exhibit while you’re at the conference.

February 17

Child Health Task Force Advisory Board Meeting

5:00-7:00pm, OKC and Tulsa

More Information

February 20-22

Oklahoma Region of Narcotics Anonymous 11th Annual General Service Assembly

Saints Grove

Glencoe, OK

More Information

February 26-27

Summit for
Children’s Mental Health

Reed Center

Midwest City

More Information

Provider reaction causes state to delay rate changes until April 1

would have been received under the originally proposed rates.

The changes were described by OHCA as a “continuing effort for unification of rates and billing codes and additional flexibility for providers using time based codes.”

The billing code changes announced for March 1 would have replaced all of the current psychotherapy rates assigned to Current Procedural Terminology (CPT) codes with Healthcare Common Procedure Coding System (HCPCS) codes.

“These changes will allow for these codes to become interchangeable on our prior authorizations through APS Healthcare, Inc., as well as to be billed in 15 minute increments versus the confusing previous timeframes,” a SoonerCare provider reimbursement notice said.

February 2009 Parents
Helping Parents Month

The City of Edmond is honoring Pat Nichols as founder of Parents Helping Parents and proclaiming February 2009 as Parents Helping Parents Month. Locals are invited to the Edmond City Council Meeting on February 23 and reception following.                    Find out more

Director asks for patience from providers

In an email announcing the delay until April 1, Debbie Spaeth, OHCA Behavioral Health Director, asked providers to be patient as the authority reworks bill codes and rate changes.

“Please do not call or email us at this time as we do not have anymore detailed answers on this today.  Once we know, we'll get the info to you so you'll know as well,” she wrote.

She outlined the objectives of the changes as allowing APS Healthcare, Inc. systems staff to develop a new simpler PA process that will involve the following:

a) same levels of care

b) same medical necessity criteria

c) new interchangeable procedure codes, so you will no longer have to tell APS how many units of each procedure code the member needs

d) new total dollar amount instead of RVUs

e) new simplified process for PA and Billing since all the procedure codes will be interchangeable and will just bill down out of the total dollar amount, and

f) decreases the need for modifications to change the array of units per procedure code, though you can still do modifications if the member changes level.

Above are the HCPCS codes and rates announced by OHCA before the re-evaluation and delay until April 1.

LBHPs may provide services through Insure Oklahoma

ThinkHealth
comes to Tulsa

Friday, March 6, 2009

OrionNet Systems is inviting any center in the Tulsa area to come see a free demonstration of ThinkHealth practice management software. On March 6, from 10am-1pm, attendees will enjoy a free lunch in the Tulsa Select Hotel as they witness an in-depth demonstration of the software. Call 405.286.1674 for details.

In January, OHCA began contracting with individual Licensed Behavioral Health Professionals (LBHPs) to provide certain outpatient services to Insure Oklahoma members.

What is Insure Oklahoma?

Insure Oklahoma is a program under the SoonerCare umbrella managed by the Oklahoma Health Care Authority.  It consists of two branches of benefits.  One branch is the Premium Assistance program geared to small businesses and offers premium subsidy assistance for qualified group health care.  The other is an individual plan designed for people who do not have access to group insurance.

HCPC

Code

Mod

Description

Billing Unit

RVU

Rate

H0004

Counseling and Therapy, Individual

15 min

.68

17.25

H0004

HR

HS

Counseling and Therapy, Family (with and w/o patient present)

15 min

.68

17.25

H0004

HQ

Counseling and Therapy, Group, age 18 and over

15 min

.19

5.33

H0004

HQ

Counseling and Therapy, Group – age less than 18

15 min

.21

5.86