Medicare Improper Payment Report for Behavioral Health Services (2015)
by Wyn Staheli, Director of Research September 24th, 2016
The following information is from the 2015 Medicare Improper Payments Report by the Department of Health and Human Services.
This table shows the Improper Payment Rates by Provider Type and Type of Error for Medicare Part B claims:
Provider Type
Improper Payment Rate
Type of Error
No Doc
Insufficient Doc
Medical Necessity
Incorrect Coding
Other
Clinical Social Worker
29.8%
0.0%
100%
0.0%
0.0%
0.0%
Clinical Psychologist
28.9%
0.0%
94.9%
5.1%
0.0%
0.0%
Psychiatry
30.8%
0.2%
96.9%
2.5%
0.0%
0.4%
Average for all provider types
29.8%
0.1%
97.3%
2.5%
0.0%
0.1%
From this table, it is easy to see that the biggest problem is lack of documentation. For more information on documentation standards, see the Behavioral Health DeskBook.
Medicare Improper Payment Report for Behavioral Health Services (2015). (2016, September 24). Find-A-Code Spotlight. Retrieved from https://www.findacode.com/articles/medicare-improper-payment-report-for-behavioral-health-services-2015-29965.html
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