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