GEHRIMED Support for Behavioral Health Specialists in LTC

Background

Psychiatrists licensed as Medical Doctors (MD’s or DO’s) have statutorily been eligible to report MIPS from the inception of the program.  Clinical Psychologists and Licensed Clinical Social Workers (LCSW) can voluntarily participate in MIPS, but they, previously, have not been statutorily required to participate.

 

In 2019, Clinical Psychologists and LCSW’s are now eligible to report MIPS.  They are still subject to be excluded from participation for the following:

 

CPT Codes specific to Behavioral Health include:

  1. 90971- psychiatric diagnostic evaluations without medical services (billed by psychologists or LCSW)
  2. 90792- initial evaluation with medical services done by a physician (Billed by Psychiatrists with licenses of MD or DO)

 

GEHIRMED Quality Measures for Behavioral Health:

 

MIPS requires that Eligible Clinicians (LCSW’s & Clinical Psychologists) report at least 6 quality measures.  One of which must be an outcome measure.  IN the absence of an outcome measure, a high-priority measure should be reported. GEHRIMED supports the following quality measures which are specific to behavioral health:

  1. #128- Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
  2. #130- Documentation of Current Medications in the Medical Record
  3. #131- Pain Assessment and Follow-up
  4. #134- Preventive Care and Screening: Screening for Depression and Follow-Up Plan
  5. #181- Elder Maltreatment Screen and Follow-Up Plan
  6. #282-Dementia: Functional Status Assessment
  7. #283- Dementia Associated Behavioral and Psychiatric Symptoms Screening and Management

**Note:  GEHRIMED does not offer an outcome measure that is activated by a behavioral health CPT code. **

 

Customized Templates

 

GEHRIMED does have several Behavioral Health templates available for use. However, these templates have all been designed for specific behavioral health groups per their respective specifications. GEHRIMED does not currently have a standard behavioral health template.  However, GPM can customize any template according to customer’s design.

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