The Status of Billing and Reimbursement in Pediatr

Authors: Jane Simpson Gray Stephanie Spear Filigno Melissa Santos Wendy L Ward Ann M Davis

Publish Date: 2012/12/08

Volume: 40, Issue: 3, Pages: 378-385

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Abstract

Pediatric psychologists provide behavioral health services to children and adolescents diagnosed with medical conditions Billing and reimbursement have been problematic throughout the history of pediatric psychology and pediatric obesity is no exception The challenges and practices of pediatric psychologists working with obesity are not well understood Health and behavior codes were developed as one potential solution to aid in the reimbursement of pediatric psychologists who treat the behavioral health needs of children with medical conditions This commentary discusses the current state of billing and reimbursement in pediatric obesity treatment programs and presents themes that have emerged from discussions with colleagues These themes include variability in billing practices from program to program challenges with specific billing codes variability in reimbursement from state to state and insurance plan to insurance plan and a general lack of practitioner awareness of code issues or reimbursement rates Implications and future directions are discussed in terms of research training and clinical serviceThe authors wish to acknowledge the important contributions of the colleagues who responded to our request for feedback about billing and reimbursement and our funding from the Michael Susan Dell Foundation to first author the National Institutes of Health DK 068221 to fifth author and the Health Care Foundation of Greater Kansas City to fifth author

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