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Washington Mental Health Fee Schedule and Billing Guidelines

State:
Washington
Control #:
WA-SKU-3203
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PDF
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Description

Mental Health Fee Schedule and Billing Guidelines

Washington Mental Health Fee Schedule and Billing Guidelines are the rules and regulations that govern how mental health services are provided and how payment for those services is handled. They are established by the state of Washington in order to ensure that all mental health providers receive fair compensation for their work. The various fee schedules and billing guidelines are designed to help practitioners understand the process for submitting claims and collecting payment. The Washington Mental Health Fee Schedule and Billing Guidelines are separated into two distinct categories: 1. Provider Fee Schedules: These are the rates established by the state of Washington for each type of mental health service provided. These rates are used to determine the amount of reimbursement for services. 2. Billing Guidelines: This includes the rules and regulations for submitting and processing claims for reimbursement. These guidelines cover topics such as coding and billing, documentation requirements, and reporting of services to third-party payers. These Washington Mental Health Fee Schedule and Billing Guidelines help to ensure that mental health providers receive fair and timely reimbursement for the services they provide.

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FAQ

A fee schedule is a comprehensive and organized list of fees or charges associated with specific products or services a business or organization provides. It outlines the cost of each product or service, enabling clients or customers to understand the financial implications of engaging with the provider.

About two weeks after you enroll in Washington Apple Health, you will receive a Services Card (also called a ProviderOne card) like the one pictured here. Keep this card. Your Services Card shows your client number, which you need to receive health services. You do not need to activate your new Services Card.

Diagnostic psychiatric evaluation is reported with 1 of 2 CPT codes. CPT code 90791 is psychiatric evaluation without medical E&M, and CPT code 90792 is psychiatric evaluation with medical E&M.

The creation of a fee schedule will state the actual dollar amount the insurance company will pay for each medical service. Knowing the actual dollar amount reduces the time spent on appeals, because there is no guesswork on the part of the medical practice and patient.

There are two types of fee schedules - insurance fee schedules and patient fee schedules. Insurance fee schedules are used when a practice is contracted with an insurance company, often referred to as in network, contracted, or PPO.

A fee schedule is a complete listing of fees used by Medicare to pay doctors or other providers/suppliers.

Procedure Code 99214 Reimbursement Rates ? Medicare CPT CodeService TimeRate9921210 minutes$46.139921315 minutes$68.109921425 minutes$110.439921540 minutes$148.33

A fee schedule is a complete listing of fees used by Medicare to pay doctors or other providers/suppliers.

More info

These tables list individual provider-type required qualifications, coverage, and payment criteria. EFFECTIVE July 1, 2019.This MLN document on Medicare Mental Health specifies what percentage of the fee schedule each practitioner type gets reimbursed:. This page contains billing guides, fee schedules, and additional billing materials to help you submit: Prior authorization (PA) for services; Claims. For patients age 65 and older or on Medicare, complete the. Washington Apple Health Application for Aged, Blind,. B. New Jersey Mental Health Application for Payment Processing . The Iowa Medicaid Provider Fee Schedules are listed below. Residential Treatment Centers for Youth. CPT License Agreement: NOTE: CPT codes and descriptions only are Copyright 2023 American Medical Association.

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Washington Mental Health Fee Schedule and Billing Guidelines