Frequently Asked Questions
Have questions about mental health screening with Connected Mind or billing mental health? We’ve provided answers to the most commonly asked clinical questions here. If you can’t find the answer to your question, please Contact Us.
Questions About Connected Mind?
How Much Does Connected Mind Cost?
Can Connected Mind be used remote or in telemedicine?
Is Connected Mind a cross-cutting measures tool?
Yes. We launch an initial screening called a Fast Check that is designed to rule out 5 conditions. If it cannot then it will continue to screen for any condition that is indicated. Using a branching logic engine it will continue to try to rule out the condition. When the assessment is complete it produces a mental health profile on the patient for up to 6 conditions and suicidality.
Learn more about Connected Mind With Fast Check
Disclaimer: The following information is meant as a general guideline and is not guaranteed to be accurate. This information should not replace the advice of a certified coder or healthcare attorney. Any dollar amounts listed are based on averages at the time and should be verified with your own insurance contracts or representatives. They are not a guarantee of payment or results.
Questions about Mental Health Billing CPT Codes?
How do I calculate minimum time for a procedure?
The minimum time for a procedure is half of the procedure time plus one minute.
Assume the procedure time is 30 minutes, the minimum time is as follows:
(30 minutes / 2) + 1 = 16 minutes
How do I bill using CPT Code 96127 with an office visit (99215) and do I need modifiers?
You would add the 25 modifier to the 99215 and a 59 modifier to the 96127.
Is CPT 96127 billable when a patient comes back and has the dx of depression but still do a screening and if so, do we use depression dx or Z code dx (Z13.89)?
96127 is a screening code to identify the potential of mental health conditions being present and works with Z13.89. 96138, 96138 would be more appropriate for the administration of an actual test to determine if the condition is actually present. And 96130 would be more appropriate for writing the report and making a treatment plan.
These codes will also pay significantly higher than the 96127.
Please refer to our billing guide which will explain in more detail.
Can a pediatrician bill code 96127 with a 99213?
Yes a pediatrician can bill 96127 with 99213. It would be billed like this:
99213 25 ICD10 code
96127 59 Z13.89
You can bill up to 4 units on the 96127 code. 1 for each screening.
Why do we keep getting denials when we bill 99213 90792 96127?
You cannot bill a 90792 with an E&M or 96127 because it is considered double-dipping.
The appropriate way to do it is as follows:
99213 25 physical exam only
96136 59 must administer assessments for at least 2 conditions and take at least 16 minutes
96130 59 must take at least 31 minutes
Overall this method pays about $100 more than the 90792 by itself.
Do I bill 96136 or 96130 for actual face to face testing?
The 96136 is for the test administration for at least 2 conditions, any method. The 96130 is for the consolidation and interpretation of the results.
When coding 96130 with an office visit, where does the modifier go?
99213 25 ICD10 codes
96130 59 ICD10 codes
Does a Supervising Licensed Psychologist have to bill for CPT 96130 or can a Psych Associate/Assistant, who receives supervision, bill for it?
Unless the psych associate/ assistant was also a licensed psychologist they could not bill for 96130. It would have to be the supervising licensed psychologist.
Can CPT code 96131 be used to code for additional 15 minutes?
96131 is used for an additional 1 hour. The minimum time is one half the time plus one minute or 31 minutes.
For 96136, do I have to get the two tests done within that half hour or can it just go into the next half hour to 96137?
The 96136 code requires that at least 2 tests are administered, but does not specify a timeframe for each. If the 2 tests take 1 hour (at least 46 minutes) then you would bill both the 96136 and 96137. If they take 1/2 hour (at least 16 minutes) then you would bill just the 96136. Also keep in mind that the consolidation and interpretation code 96130 can be used along with the other 2 codes if you interpret the results.
The interpretation code 96132 is for Neuropsych testing and 96130 is for psychological
Can I bill 96138 and 96139 together?
You can. You would bill 96138 for the first 30 minutes and 96139 for each additional 30 minutes.
Please note, to qualify as 30 minutes it needs to be at least 16 minutes. Example – administering an assessment that takes 106 minutes would be billed
96139 3 units
What modifier should go with the 99408 alcohol screening?
It is modifier 59, however, insurance no longer pays for 99408 and 99409. You can still use G0442 for medicare once per year. You may consider 96127 for the screening portion, or if you are looking for substance use and any other comorbid condition together you can bill 96138 for administering those tools.
Is 96146 still a valid CPT code?
Yes, 96146 is still valid.
How long is a Psychological Evaluation valid for under Medicare Wellness?
For example: If a patient had one in 2018 is it still considered valid or would she need to have a current one to proceed with a medically necessary procedure? The procedure is a Spinal Chord Stimulator and a CMS requirement for the procedure is to have had a Psychological Evaluation. Her last Psychological Evaluation was in 2018.
There is nothing in the Medicare articles or the NCCI guideline that define a timeframe for Psych evals in this context. The spirit of the evaluation is to ensure that a patient is not suffering from a psychological condition that could affect the outcome of the procedure. Since a previous evaluation should have uncovered long term issues like bipolar disorder, borderline personality disorder, or schizophrenia it makes sense that the older evaluation would work for those cases. However, testing for conditions that could have presented themselves since the evaluation, such as MDD, GAD, SSD, SUD would make logical sense.
Since there is no clear direction, you will need to use your best judgement. Feel free to utilize our free public assessment to check for MDD, GAD, SSD, SUD. The patient can take it at https://connectedmind.me/screen-4-life/ it will give you instructions at the bottom of the report so your office can convert it to a full clinical version with DSM-V criteria.