How do I prepare for a partial hospitalization program?

But you will need to go through a bit of preparation and planning before you can take advantage.

1. Step 1: Get an assessment.
2. Step 2: Determine your insurance benefits.
3. Step 3: Determine the treatment plan.
4. Step 4: Understand the schedule.
5. Step 5: Determine next steps.
6. Using Your PHP the Right Way.

What can I expect from a partial hospitalization?

What to Expect from Partial Hospitalization. A typical day consists of individual and group therapy, psychoeducation, skill-building practice, and periodic evaluations. A licensed mental health professional conducts all of these. If medication is needed, you will meet with a staff psychiatrist for medication management …

How do you use modifier 95?

Physicians should append modifier -95 to the claim lines delivered via telehealth. Claims with POS 02 – Telehealth will be paid at the normal facility rate, which is typically less than the non-facility rate under the Medicare physician fee schedule.

What does CPT code 90899 mean?

Other Psychiatric Services or Procedures
CPT® 90899, Under Other Psychiatric Services or Procedures The Current Procedural Terminology (CPT®) code 90899 as maintained by American Medical Association, is a medical procedural code under the range – Other Psychiatric Services or Procedures.

What are the requirements for a partial hospitalization program?

Partial hospitalization programs may either be free standing or integrated with a broader mental health or medical program. Partial hospitalization must be a separate, identifiable, organized program representing a significant link within the continuum of comprehensive mental health services.

How to bill for Partial Hospitalization Program ( PHP )?

Partial Hospitalization Program (PHP) services must be billed with below revenue codes and a CPT or HCPCS code descripting encounter CMS IOM, Publication 100-04, Medicare Claims Processing Manual, Chapter 4, Section 260.1.1C A PHP is furnished by a hospital to outpatients that provides parital hospitalization services.

How does Medicare cover partial hospitalization of patients?

Medicare helps cover partial hospitalization services you get through a hospital outpatient department or community mental health center. Medicare only partial hospitalization coverage only applies if the doctor and the program accept Assignment.

How long does a partial hospitalization service last?

Partial hospitalization services are a distinct and organized intensive ambulatory psychiatric treatment program that offers less than twenty-four hour daily care to patients who either: Treatment includes a multidisciplinary team approach to care under direction of a physician and for a minimum of 20 hours per week