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Sandhills Center increases rates for Evaluation and Management Codes

Sandhills Center increases rates for Evaluation and Management Codes

Publication Date: January 28, 2016

Sandhills Center, the organization responsible for public mental health, intellectual/developmental disability and substance abuse services in Anson, Guilford, Hoke, Harnett, Lee, Moore, Montgomery, Randolph and Richmond counties, has announced it is increasing the reimbursement rate to providers of the medical service, Evaluation and Management (E&M) Coding by 13 percent. The new reimbursement rate for this billing process will increase on July 1, 2015.

E&M codes allow psychiatrists, non psychiatric physicians, physician assistants, and nurse practitioners the ability to effectively plan and monitor integrated treatment around clinical history, examination, and medical decision making. It allows individuals to receive treatment based on their individual history with an assessment and clinical care plan based on their individualized needs. It allows the provider the opportunity to be reimbursed for the care provided – both in the amount of time counseling the member and in the amount of time coordinating care for the member. This coordination of care is equally important as it supports the expectation that licensed clinicians and contracted providers work within an integrated physical and behavioral health framework that is accountable for achieving objective and sustained improvements in patients’ outcomes including various quality indicators of behavioral and physical health.

By increasing the E&M code rates, Sandhills Center is supporting licensed clinicians and providers in this integration of care work and is continuing its commitment to ensuring members receive the highest quality, medically necessary care available by contracted providers with the expertise to meet the individual’s clinical need. The July 1, 2015 rate increase follows earlier rate increases for Outpatient services, Assertive Community Treatment Team services and Multi-Systemic Therapy that were effective October 1, 2014.

“One of the benefits of Sandhills Center becoming a 1915 (b)/(c) waiver site for managing services was that we could reinvest savings back into our local communities. Today, we have the opportunity to do that. We are pleased to increase the E/M Coding rate to assist our provider network to offer high quality services to our members”, said Victoria Whitt, Chief Executive Officer for Sandhills Center.