Billing, Codes & Reimbursement
These are some of the most common diagnoses occupational therapists treat in inpatient mental health
What are depression, anxiety, mood disorders, schizophrenia and suicidal ideation?
To qualify for reimbursable OT services, clients must demonstrate they can improve a specific skill.
What is rehab potential?
Limited reimbursement and time often forces therapists to make these difficult decisions
What is prioritizing treatment?
This is the most widely used CPT code in mental health.
What is 97150 -Therapeutic procedure(s), group (2 or more)?
One change that could improve reimbursement
What is increasing education for insurance reviewers?
This source of reimbursement dictates almost all fields in healthcare but mental health.
What is Medicare?
This is the level of care between weekly therapy and hospitalization, providing more intensive care than outpatient.
What is Intensive Outpatient Program (IOP)?
Surprisingly, this is not frequently used in the mental health field, while it is the most commonly used independence measure.
What is GG code?
When the client has no insurance coverage, this is the common source of funding.
What are “Grants”? (state/government funding)
This word can raise concerns with insurance because it suggests the client is no longer making measurable progress.
Maintenance-
Words like maintenance can increase the likeliness of denied services
This is how reimbursement practices influence OT mental health practice.
What are reimbursement restrictions on OT roles in community mental health, reducing access, and pushing mental health OT into medical or inpatient settings rather than community wellness programs?