Introduction:

Keeping up with the ever-changing world of health insurance coding can be a daunting task for behavioral health providers. Recently, there have been several updates to Place of Service (POS) codes that may impact your practice. In this post, we’ll break down the latest changes and provide guidance on how to ensure your claims are processed smoothly.

Understanding POS Codes:

POS codes indicate the physical location where services are provided. They are crucial in determining reimbursement rates and compliance with payer policies. For example, services provided in an office (POS 11) are reimbursed differently from services provided via telehealth (POS 02 or POS 10).

What’s Changed?

1. Telehealth Updates:

   • New POS codes 02 and 10 now distinguish between telehealth provided in a patient’s home (POS 10) and outside the home (POS 02).
   • Ensure that your claims reflect these changes to avoid denials.

2. Outpatient Behavioral Health:

   • Updates to POS 57 for non-residential opioid treatment facilities now require additional documentation for reimbursement.
   • If your practice offers these services, be sure to review your coding and documentation procedures.

3. Community Mental Health Centers (CMHC):

   • POS 53 has expanded to include more comprehensive behavioral health services.
   • Verify that your claims align with the updated service descriptions.

How to Stay Compliant:

• Verify Payer Guidelines: Check each payer’s specific requirements for POS codes to ensure you’re using the correct ones.
• Update Your EHR System: Ensure your electronic health record (EHR) system is up-to-date with the new codes.
• Educate Your Staff: Conduct training sessions for your billing team to avoid common coding errors.

Conclusion:

Staying on top of coding changes is essential for maintaining a healthy revenue cycle. If you’re unsure about how these updates affect your practice, don’t hesitate to reach out for assistance. Our team specializes in decoding these changes and ensuring your claims are in compliance.

CTA: Need help navigating POS coding updates? Contact us today for expert guidance.