Pediatric primary care psychologists' reported level of integration, billing practices, and reimbursement frequency

Andrew R. Riley, Allison Grennan, Kathryn Menousek, Kathryn W. Hoffses
2018 Families, Systems & Health  
Introduction-Integration of psychological services into pediatric primary care is increasingly common, but models of integration vary with regards to their level of coordination, co-location, and integration. High-integration models may provide some distinct advantages, such as preventative care and brief consultation for sub-clinical behavior concerns; however, psychologists face barriers to seeking reimbursement for these services. Alternatives to traditional psychotherapy and psychological
more » ... sting codes, specifically Health & Behavior (H&B) codes, have been proposed as one method for supporting integrated care. The aim of this study was to investigate the relationships between psychologists' reported billing practices, reimbursement rates, and model of integration in pediatric primary care. Method-As part of a larger survey study, 55 psychologists working in pediatric primary care reported on characteristics of their practice's model of integration, billing practices, and frequency of reimbursement for consultative services. Results-Compared to those who categorized their integrated care model as Co-located, psychologists who endorsed working in Integrated models reported a significantly higher usage of H&B codes and more frequent reimbursement for consultations. Overall, use of H&B codes was associated with higher reported levels of coordination and integration. Discussion-Survey results showed a clear pattern of higher integration being associated with greater utilization of H&B codes and better reimbursement for consultation activities. These results underscore the importance of establishing and maintaining billing and reimbursement systems that adequately support integrated care.
doi:10.1037/fsh0000306 pmid:29172627 pmcid:PMC5880712 fatcat:wd4jyjmfgnb57br5qha4sa3rw4