the billing code. My son and daughters counselors and psychiatrists have been using 314.01 which is paid at 50%. Blue Cross says there are different codes that can be used which pay more but they can't tell me what they are. Has anyone else encountered this problem?
Q: I have a Blue Cross health plan that will either pay 50% or 90% for mental health depending on
Answers (1)
9/17/08 12:08pm
Hi Mitch:
You are talking about a diagnosis code of ADHD. If your children have other diagnoses that a professional has given them, such as depression or anxiety, BC/BS may pay more. On the other hand, they often assign payment according to the treatment code, rather than the diagnosis code. Treatment codes for psychotherapy or other treatment vary according to your State's BC/BS payment schedule. They also vary according to what level the provider is, for instance, a LCSW will not get as much as a Ph.D. and a Ph.D., does not get as much as an M.D.
I hope this helps,
Dr. Diana Walcutt
Important:
We hope you find this general health information helpful. Please note however, that this Q&A is meant to support not replace the professional medical advice you receive from your doctor. No information in the Answers above is intended to diagnose or treat any condition. The views expressed in the Answers above belong to the individuals who posted them and do not necessarily reflect the views of The HealthCentral Network. The HealthCentral Network does not review or edit content posted by our community members, but reserves the right to remove any material it deems inappropriate.
Featuring Content From:
By using this service, you accept our Terms of Use. Please read them. The consumer health information on is for informational purposes only and is not a substitute for medical advice or treatment for any medical conditions. You should promptly seek professional medical care if you have any concern about your health, and you should always consult your physician before starting a fitness regimen. Copyright © 2012 Remedy Health Media, LLC. All Rights Reserved.
