According to a just-released statistical brief from the U.S. Department of Health and Human Services Agency for Healthcare Research and Quality, mental disorders were the most costly medical expenditure for those under 18 years of age during 2011, the most recent year for which statistics are available. More than 5.6 million children were treated for mental disorders at a mean expenditure of $2,465 each, for a total expense of $13.8 billion. In 2011, $117.6 billion was spent overall on the medical care and treatment of children.

The top five medical conditions that ranked highest in terms of spending included mental disorders, asthma ($11.9 billion), trauma-related disorders ($5.8 billion), acute bronchitis and upper respiratory infections ($3.3 billion), and otitis media ($3.2 billion). Although mental disorders affected the fewest number of children of the other top five medical conditions, they had the highest average expense per child.

In 2008, mental disorders ranked as the fifth most commonly treated condition; according to survey data, the expense per child has remained steady.

Nearly half the expenditures for mental disorders in children were paid by Medicaid.
New current procedural terminology (CPT) codes went into effect January 1 of this year, marking the first overhaul of the codes used to describe psychotherapy treatment since 1998. The only codes that were revised were the psychotherapy family of codes – codes used to describe testing, health, and behavior remain unchanged.

Reports of the new codes causing major glitches for many providers have started to surface. Many third-party payers, including Medicare and Medicaid, were not updated to recognize the new claim codes, causing delays for payment and denials for service. Though steps are being taken steps to rectify these issues, many providers have not received payment for the work they have done this year.

The American Psychological Association’s coding Web site has had more than 300,000 hits in the past month and has published an extensive list of questions on how to handle this transition and what to do if you are being denied payment. For more information on the new codes, APA has published a special issue.

What has your experience been with the new CPT codes?