Gain a better understanding of how to properly use and bill HCPCS code H0031 with our short guide that has a list of documentation and billing requirements.
HCPCS code H0031 is specifically for mental health assessments performed by non-physician providers. CPT code 90791 is for a "psychiatric diagnostic evaluation" and is typically used by psychiatrists or other physicians.
Understanding the distinction between these two codes supports accurate diagnosis, promotes improved mental health outcomes, ensures compliance with the Health Insurance Portability and Accountability Act (HIPAA), and helps facilitate proper reimbursement.
Yes, H0031 can be used for an initial intake or an annual mental health assessment, but you must check with the payer, as some may limit the code to one use per year.
Common reasons for denial include insufficient documentation, billing for services not covered by the specific payer, using the incorrect provider type, failing to adhere to billing unit rules, or not using the required modifiers. Implementing a comprehensive compliance program can help reduce claim denials and support accurate code usage.
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