It goes without saying that you should read any contract carefully before
you sign it. One item you need to look for on contracts with managed care
organizations (MCOs) is a limitation on the procedural codes (CPT codes) for
which they are willing to pay you. APA's Managed Care Help Line has learned
that some MCO contracts limit the CPT codes for which they will reimburse
psychiatrists to the psychiatric codes only (the 908xx series of CPT codes).
As a psychiatrist, of course, you are entitled to use any CPT code that
accurately describes the care you provide, including evaluation and management
services denoted by the 99xxx series of CPT codes. However, if you have signed
a contract limiting you to the use of psychiatric codes only, you will not be
paid for anything else. If you have any questions about this limitation,
please call the Managed Care Help Line at (800) 343-4671.