Updated 2023 Behavioral Health Billing Laws

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The landscape of behavioral health billing is constantly evolving, and 2023 brings forth new laws that will have a significant impact on billing processes for behavioral health billers, admins, and managers. It is crucial for professionals in this field to stay updated and understand these new changes to ensure compliance and maximize reimbursement.

In this article, we will dive into the details of 2023 behavioral health billing laws and provide actionable insights that behavioral health billers need to know. Let’s explore how these changes can be navigated effectively to streamline billing processes and optimize revenue collection as you collaborate with payers.

The Key Changes in 2023

Enhanced Documentation Requirements:

Starting in 2023, new enhanced documentation requirements will apply to certain behavioral health billing codes. These requirements include additional documentation elements and stricter rules around what kind of documentation is acceptable for billing purposes. The changes are designed to help improve the accuracy of claims submissions and reduce fraud, waste, and abuse in the healthcare system. Additionally, new healthcare billing codes will be introduced, allowing for greater flexibility and specificity in describing care services. Here is a more detailed explanation of what these enhanced documentation requirements entail:

  1. Time Requirements: Providers are required to document the time spent on each service delivered. This documentation should cover the start and stop time of the service and the total duration of the service. This will help billers to accurately calculate the billable time and submit claims accordingly.
  2. Medical Necessity Documentation: Medical necessity documentation is required for all services offered. The documentation should justify the need for the service and explain how it aligns with the patient’s diagnosis and treatment plan.
  3. Treatment Plan Documentation: The treatment plan documentation should include the patient’s diagnosis, the goals of the treatment, the interventions that will be used, and the duration of the therapy. Providers are required to review and update this plan regularly.
  4. Progress Notes: These notes should be regularly updated to reflect patient progress, outlining any changes in treatment, medication, or any other relevant information. It should reflect the patient’s response to therapy. Progress notes should be comprehensive and describe the scope and the level of the service provided.
  5. Medication Management Documentation: Documentation is required to show the medication prescriptions, the dispensation records, and any changes made to the prescriptions. The documentation should also reflect the patient’s response to medication and should provide information on any adverse drug reactions.
  6. Consent Form Documentation: Providers should document the patient’s consent to receive services, including telehealth services. The consent form must be comprehensive, outlining any potential risks, benefits, and limitations of services provided.

Behavioral health billers must keep in mind that these documentation requirements differ for different types of services. For instance, documentation requirements for family therapy services will differ from those required for individual therapy services. Therefore, it’s essential to be aware of these differences and incorporate them into the documentation process. Failure to comply with these requirements could lead to claim denials or delayed payment, hence the need for accurate and comprehensive documentation practices.


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Revised Billing Codes:

The 2023 Medicare Physician Fee Schedule (MPFS) introduces revised billing codes for psychiatric diagnostic evaluation and combined diagnostic and treatment services. The updated codes now differentiate the time required for services delivered in various settings, including outpatient, inpatient, and emergency department services. This update aligns billing codes with service delivery and the corresponding resource utilization.

Expanded Telehealth Coverage:

Due to the COVID-19 pandemic, telehealth services saw a significant increase in adoption, prompting the US government to introduce new measures to encourage continued telehealth use. In line with this, The Centers for Medicare & Medicaid Services (CMS) has continued coverage for telehealth services. Some notable changes include the introduction of new telehealth codes, updated payment rates for specific care services, and relaxed regulations for telehealth and virtual patient care during the COVID-19 pandemic. These changes aim to provide more support for care management and telephone visits. It is crucial for healthcare providers to review the final 2023 MPFS rules to understand the impact on their practice and billing procedures.

Adapting to the Changes – How Logik Can Help

Navigating the complex landscape of behavioral health billing requires the right tools and expertise. This is where Logik can assist you. With over 30 years of experience in transforming the billing processes of health organizations, Logik offers solutions that improve revenue collection, billing processes, and patient management.

Our powerful health billing software is designed to maximize your revenue. It simplifies every aspect of billing, from charge generation to collections, while improving your clean claims rate and accelerating cash flow. Our software is specifically built for enterprise-level behavioral health practices, addressing the unique needs and insurance requirements of this market.

In addition to our advanced technology solutions, Logik provides industry expertise to help you identify new opportunities and optimize workflows. We understand the operational strategies that enable behavioral health practices to thrive. From improving claims and patient management to implementing specialized software, we help you create efficiencies and streamline your processes.

With Logik, you can benefit from:

  • Streamlined billing processes
  • Optimized clean claims rate
  • Increased revenue collection
  • Improved patient management
  • Accurate and compliant billing practices

Schedule a demo to learn more about how Logik’s solutions can transform your behavioral health billing processes. Visit our website here for more information about Logik and our services.

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