Reimbursement Rate Assignment

Reimbursement Rate Assignment

Reimbursement Rate Assignment,Reimbursement rates and medical coding can be almost as complicated as treating some mental illnesses. As a PMHNP, you will be faced with varying rates that may be different than other health care providers you may work with. In this Practicum Journal Assignment, you will analyze reimbursement rates for mental health treatments you will likely use in your practice and compare those rates to other provider rates. To prepare for this Practicum Journal: Research reimbursement rates for various treatment modalities. Compare Nurse practitioner rates to other provider rates. For this Practicum Journal: Complete the Reimbursement Rate Template in your Learning Resources using the five types of services you are likely to use in your practice.Reimbursement Rate Assignment,Current Procedural Terminology (CPT) is the system used by the third-payers to specify and describe the provided care services to facilitate reimbursement from health insurance companies and Medicaid. Mental health practitioners use the CPT codes for billing the provided care services, including psychotherapy services (Chang, 2016). However, mental health practitioners have lower reimbursement from insurance firms when compared to other health practitioners (Sarzynski & Barry, 2019). The disparity in reimbursement from insurance firms is likely to hinder access to mental health services because mental health practitioners may reject the low reimbursements from insurance companies. This paper will thus analyze reimbursement rates for the selected mental services and compare the rates for the PMHNPs against rates from physicians.Reimbursement Rate Assignment,Reimbursement Rate Template,reimbursement rate for PMHNP,reimbursement rate for physician, , ,The table above shows that the reimbursement rates for physicians are significantly higher in comparison to the reimbursement rates of PMHNPs. Insurance firms, including Medicare, reimburse physicians higher than the PMHNPs. For example, for psychiatric diagnostic evaluation, the Medicare reimbursement rate for a PMHNP is $ 101.847 while for a physician is $119.82. For the same service, the reimbursement rate for a PMHNP from a private insurance firm is $ 142.15 while that of a physician is $ 157.194. This clearly shows that the physicians have reimbursement rates than PMHNPs and also Medicare has lower reimbursement rates when compared to private health insurance firms. A study conducted by Leslie-Mazwi et al (2016) showed that NPs like PMHNPs are reimbursed for 85% of the reimbursement rate for the physicians. The reimbursement rates for the NPs and in this PMHNPs vary according to the states (Sarzynski & Barry, 2019). This means that the insurance firms do not have a standard rate for reimbursing PMHNPs.,The issue of reimbursement for the PMHNPs needs to be addressed to support fair reimbursement for this group of healthcare practitioners. The policy-makers, in collaboration with the health insurance firms, should come up with a standard and fair reimbursement rates for PHMNPs (Barnes et al., 2017). This will enable patients and consumers with standard and user-friendly information about the costs and the available mental health practitioners in specific health insurance networks. As such, consumers and patients will be able to make informed decisions, particularly when it comes to the cost of healthcare services. Patients and consumers will also be able to know the available treatment costs and the cost.Reimbursement Rate Assignment,References,Barnes, H., Maier, C. B., Altares Sarik, D., Germack, H. D., Aiken, L. H., & McHugh, M. D. (2017). Effects of Regulation and Payment Policies on Nurse Practitioners’ Clinical Practices. Medical care research and review: MCRR, 74(4), 431–451. https://doi.org/10.1177/1077558716649109.,Chang J. (2016). CPT 101: An Introduction to Coding and Reimbursement. Journal of the American Academy of Child & Adolescent Psychiatry, 55(10), S34.,Leslie-Mazwi T, Nicola G, Donovan W &Barr H. (2016). Current Procedural Terminology: History, Structure, and Relationship to Valuation for the Neuroradiologist. American Journal of Neuroradiology, 37 (11), 1972-1976.,Sarzynski, E., & Barry, H. (2019). Current Evidence and Controversies: Advanced Practice Providers in Healthcare. The American journal of managed care, 25(8), 366-368.,Reimbursement_rates_example_paper,Reimbursement Rate Assignment, 

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