Article archive / June 1, 2013
Originally published: . Volume 4, No. 10. Source pages: 8.
The state medical board issued an Advisory Opinion on May 7, requested by Dr. Jim Quillin, Chair of the Medical Psychology Advisory Committee. The Opinion confirmed that medical psychologists could use Evaluation and Management Codes, typically used by physicians for short services involving medication checks.
The May 7 notice on the medical board’s web site noted, “State law and regulations authorize medical psychologists to prescribe medications related to the treatment of mental disorders and to undertake the medical evaluations that are required to manage these medications in accordance with widely accepted standards of care. It is the Opinion of the Board accordingly that medical psychologists are authorized to utilize E/M codes when billing for services provided for management of psychiatric disorders.”
In an opinion letter obtained by the Times, signed by current medical board Executive Director Robert Marier, MD, and addressed to Chairman of the Medical Psychology Advisory Committee, Jim Quillin, PhD, MP, Dr. Marier wrote that the board reviewed Quillin’s request on December 3, 2012. According to the letter, Dr. Quillin had asked the medical board for an advisory opinion as to whether the Medical Psychology Practice Act “allows for MPs to perform the single system psychiatric examination as defined by CMS.” [CMS: Centers for Medicare & Medicaid Services.]
Marier wrote that the board reviewed the state laws and regulations, the Medical Psychology Practice Act, and the Louisiana Administrative Code for Medical Psychologists, noting that these, “… authorize medical psychologists to prescribe medications for the treatment of psychiatric conditions. The requirements for licensure as a medical psychologist include training in components of the history and physical examination and in the assessment of findings that relate to the medications that they prescribe. Indeed medical psychologists are required to undertake such evaluations by way of meeting the widely accepted standard of care for patients on these medications.”
“More specifically,” he wrote, “it was noted that medical psychologists assess vital signs, and appearance on most patients on medications and musculoskeletal status on patients being treated with neuroleptic agents due to risks of extrapyramidal effects, pseudo parkinsonism, tardive dyskinesia and dystonias. Needless to say a detailed psychiatric examination is undertaken on all patients.”
Dr. Marier explained that it was the opinion of the Board that Medical psychologists licensed under the Board are authorized to utilize E/M codes when billing for services provided for management of psychiatric disorders.
In February the Times reported on Magellan Health Services, the company now managing behavioral health services for the state, and the different fees listed. (See Vol 4, No 6) In that report, medical psychologists were not listed as able to bill for the 10 minutes office visit code or the office consultation code, both Evaluation and Management codes.
The 10-minute Office Visit was listed to be reimbursed at $25.73 and the 15-minute Office Consultation was listed at $43.43, two of the highest paid codes. A 15-minute Health & Behavior Intervention, listed by Magellan as reimbursed at $15.30, was one of the lowest.
The Louisiana State Board of Medical Examiners issued an opinion, requested by Dr. Jim Quillin, asking if medical psychologists could use Evaluation and Management codes. Above, a previous meeting of the Medical Psychology Advisory Committee. Dr. Quillin (L), Dr. Robert Marier (C), who is the outgoing Executive Director of the Medical Board, and Dr. Warren Lowe.
This article is part of a historical newspaper archive. Read the original issue for its original layout, photographs and graphics.