decisionhealth Newsletters, Answer Books - 2008 Issue 5 (May)
Medicare_Carriers_Manual / 2150 / 2150
Subscribe or sign in to view the full article.
Article Overview
This Medicare Carriers Manual section provides public guidance on clinical psychologist services under Medicare Part B. It addresses who qualifies as a clinical psychologist, the types of services that may be covered, incident-to and bundled service issues, consultation expectations, payment handling, and related outpatient mental health limitations. The article is relevant to psychologists, physician billing staff, and Medicare coding and compliance professionals reviewing mental health service coverage.
Why This Topic Matters
It helps readers understand how Medicare treats clinical psychologist services and related billing rules, which is important for compliance, coverage review, and claim preparation in behavioral health settings.
Article Sections
-
Ed. Note
A brief editorial note pointing readers to related material elsewhere in the manual.
-
2150. Clinical Psychologist Services
An overview of Medicare rules governing clinical psychologist services, including historical coverage context and general service categories.
-
A. Clinical Psychologist Defined
The qualifications and licensure-related criteria used to identify a clinical psychologist for Medicare purposes.
-
B. Qualified Clinical Psychologist Services Defined
General coverage scope for diagnostic and therapeutic services furnished by qualified clinical psychologists and the role of state authorization.
-
C. Types of Clinical Psychologist Services That May Be Covered
A discussion of service categories that may be covered and the general conditions associated with incident-to services and practice settings.
-
D. Noncovered Services
A discussion of services that are excluded from coverage or otherwise not payable under Medicare when furnished by clinical psychologists.
-
E. Requirement for Consultation
Documentation and physician-consultation expectations tied to enrollment and patient care coordination.
-
F. Payment Methodology Limitation
General rules describing how payment is determined for covered clinical psychologist services.
-
G. Outpatient Mental Health Services Limitation
A summary of the outpatient mental health limitation applied to covered therapeutic services and the distinction for diagnostic services.
-
H. Assignment Requirement
A short statement on claim filing and assignment requirements for covered services.
What You Will Learn
- How Medicare describes the scope of clinical psychologist services
- What general qualifications are associated with clinical psychologist status
- Which broad categories of services may be covered or excluded
- What consultation and documentation expectations are discussed
- How payment and assignment rules are addressed in this manual section
- How outpatient mental health limitations relate to covered services
Who Should Read This
- Clinical psychologists
- Behavioral health billing staff
- Medicare compliance professionals
- Medical coders
- Practice administrators
Codes Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com