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J Behav Health Serv Res. 2013 Jul;40(3):378-85. doi: 10.1007/s11414-012-9308-9.

The status of billing and reimbursement in pediatric obesity treatment programs.

Author information

  • 1Texas Center for the Prevention and Treatment of Childhood Obesity, Texas Child Study Center, Dell Children's MedicalCenter, 4900 Mueller Blvd, Austin, TX 78723, USA. jsgray@seton.org

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 service.

PMID:
23224661
[PubMed - indexed for MEDLINE]
PMCID:
PMC4106796
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