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Psychiactric Diagnosis-CB

Lina Posted Thu 19th of February, 2015 10:29:51 AM

In the past Mississippi Medicare would only pay 50% of the allowed charges if a psychiatric diagnosis in a primary care office. Do you know if this is still true? If we bill depression diagnosis 311 with a cpt code of 99213, will be only get paid 50% of the allowed charges?

SuperCoder Answered Fri 20th of February, 2015 10:11:47 AM

Thanks for your question. You are correct, Medicare once reduced psychiatric services by 50%. Starting in 2014, Medicare now covers claims with psychiatric codes at 80% leaving the beneficiary responsible for 20%. See the attached link for the reimbursement rates.

https://www.noridianmedicare.com/provider/updates/docs/why_has_my_allowed_or_paid_amount_been_reduced.pdf

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