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Psychiatric Practice and Managed Care
Contract Alert
Psychiatric News
Volume 39 Number 23 page 20-20

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.

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