ESSAY: Racism in the US and how to be educated and surrounding themselves with other cultures/races

NURS 6670

The Current Procedural Terminology (CPT) refers to a medical coding system that reports surgical, diagnostic, and medical services and procedures to professionals such as health insurance firms, physicians, psychiatrists, and accreditation institutions. The American Medical Association (AMA) created the system to accurately identify and report medical professionals’ services in a way that other entities can universally understand. The CPT system is an essential part of the billing process of medical professionals and combined with ICD-10 codes allows insurance to cover a procedure and reimburse a health service provider. The rates for reimbursement, however, differ from one expertise to another in the medical field. For instance, the PMHNP reimbursement rates vary from those of physicians. In contrast to physicians, PMHNP’s practices are on a much smaller scale with regards to finance, specialized medical equipment, staffing requirements. This results in a disparity that overburdens the PMNHP’s practices who are consequently unable to fully collect a considerable reimbursement amount from the insurance companies (Kohler, 2015).

To that effect, this paper analyzes the rates of reimbursement for various psychiatric treatments to utilize in my practice. Presently, the rates of reimbursement for five different modes of treatment are available. The five methods are individual psychotherapy 30 minutes for outpatient, psychiatric diagnostic evaluation, group therapy (not multi-family 45-60 minutes), and 45 minutes with patient or family member, and psychotherapy 60 minutes with patient and/or family member. These five types of services will complete the table below from the AMA (2017).

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Table: Reimbursement Rate Template

Type of Service eg. -New office visit -Established office visit -Inpatient hospital -individual psychotherapy -group psychotherapy (see examples below)CPT codePrivate insurer reimbursement rate for PMHNPPrivate insurer reimbursement rate for physiciansMedicare the reimbursement rate for PMHNPMedicare the reimbursement rate for physician
Psychiatric Diagnostic Evaluation  90791$123.4$151.75$116.79$124.96
Individual Psychotherapy 30minutes outpatient  90832$60$74.25$35.67$41.72

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