HCPro, JustCoding Outpatient - 2022 Issue 16 (April)
Healthcare News: OIG estimates New York provider received $1.1 million in Medicare overpayments for psychotherapy services
April 19th, 2022
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Article Overview
This article summarizes an Office of Inspector General audit involving psychotherapy services billed to Medicare by a New York City provider. It explains the audit’s purpose, the general types of billing and documentation concerns reviewed, the estimated overpayment identified, and the recommendations made to the provider. The piece is relevant to compliance, behavioral health billing, and Medicare Part B oversight.
Why This Topic Matters
It highlights how documentation and billing compliance issues in behavioral health can lead to significant Medicare overpayment findings and corrective-action recommendations. The article is useful for compliance staff, auditors, behavioral health practices, and coders working with psychotherapy services.
What You Will Learn
- What prompted the OIG review of psychotherapy billing
- What types of psychotherapy service claims were sampled
- What broad documentation and billing compliance issues were identified
- What the OIG recommended in response to the audit findings
Who Should Read This
- Medical coders
- Billing specialists
- Compliance professionals
- Behavioral health practices
- Audit and reimbursement staff
Codes Discussed
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