Table 6. 2. Other Pediatric Mental Health Screening/Assessments Recommendation Examples of Acceptable Billing Guidelines Limitations Standardized Tools ADHD AAP clinical policy 96127: Brief emotional/ A maximum of 2 units of 96127 will be Vanderbilt ADHD Assessment recommends use of behavioral assessment may reimbursed per visit Diagnostic Rating Scales – parent and teacher be billed only when a Parent and Teacher ratings scales as a component standardized screening tool Conners-3 Ratings Scales of screening/diagnosis when is used and results ADHD Rating Scale-5 for there is concern documented. Children and Adolescents Other Disorder-focused mental 96127: Brief emotional/ A maximum of 2 units of 96127 will be Screen for Childhood mental health screening and behavioral assessment reimbursed per visit may Anxiety Related Disorders health screening/ assessment tools may be used be billed only when a (SCARED) assessment when there is a specific standardized screening tool Anxiety Spence Children’s concern, ex. anxiety is used and results Scale documented. ADHD AAP clinical policy 96127: Brief emotional/ A maximum of 2 units of 96127 will be Vanderbilt ADHD Assessment recommends use of behavioral assessment may reimbursed per visit Diagnostic Rating Scales – parent and teacher be billed only when a Parent and Teacher ratings scales as a component standardized screening tool Conners-3 Ratings Scales of screening/diagnosis when is used and results ADHD Rating Scale-5 for there is concern documented. Children and Adolescents Other Disorder-focused mental 96127: Brief emotional/ A maximum of 2 units of 96127 will be Screen for Childhood mental health screening and behavioral assessment may reimbursed per visit Anxiety Related Disorders health screening/ assessment tools may be used be billed only when a (SCARED) assessment when there is a specific standardized screening tool Anxiety Spence Children’s concern, ex. anxiety is used and results Scale documented.
Table 6. 2. Other Pediatric Mental Health Screening/Assessments Recommendation Examples of Acceptable Standardized Tools Billing Guidelines Limitations ADHD Assessment AAP clinical policy recommends use of parent and teacher ratings scales as a component of screening/diagnosis when there is concern Vanderbilt ADHD Diagnostic Rating Scales – Parent and Teacher Conners-3 Ratings Scales ADHD Rating Scale-5 for Children and Adolescents 96127: Brief emotional/ behavioral assessment may be billed only when a standardized screening tool is used and results documented. A maximum of 2 units of 96127 will be reimbursed per visit Other mental health screening/ assessment Disorder-focused mental health screening and assessment tools may be used when there is a specific concern, ex. anxiety Screen for Childhood Anxiety Related Disorders (SCARED) Spence Children’s Anxiety Scale 96127: Brief emotional/ behavioral assessment may be billed only when a standardized screening tool is used and results documented. A maximum of 2 units of 96127 will be reimbursed per visit ADHD Assessment AAP clinical policy recommends use of parent and teacher ratings scales as a component of screening/diagnosis when there is concern Vanderbilt ADHD Diagnostic Rating Scales – Parent and Teacher Conners-3 Ratings Scales ADHD Rating Scale-5 for Children and Adolescents 96127: Brief emotional/ behavioral assessment may be billed only when a standardized screening tool is used and results documented. A maximum of 2 units of 96127 will be reimbursed per visit Other mental health screening/ assessment Disorder-focused mental health screening and assessment tools may be used when there is a specific concern, ex. anxiety Screen for Childhood Anxiety Related Disorders (SCARED) Spence Children’s Anxiety Scale 96127: Brief emotional/ behavioral assessment may be billed only when a standardized screening tool is used and results documented. A maximum of 2 units of 96127 will be reimbursed per visit
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