What Services and Codes are not reimbused?

V codes are rarely covered by insurers. We have also seen instances of claims denials when a V code was used as a secondary diagnosis. Best not to use V codes for billing purposes.

Telephone therapy is typically not reimbursed by payers.

Telepsychiatry is reimbursed by many private insurers, but not by all. Telepsychiatry services in nursing homes and community mental health centers are reimbused by Medicare. Medicaid also reimburses for telepsychiatric services in 24 states.

Certain diagnoses are also not covered, depending on the payer. Commonly excluded diagnoses include:
-Mental Retardation
-Learning Disabilities
-ADHD Adult
-ADHD Child
-Substance abuse
-Self inflicted injuries

Also, intensive outpatient services such as partial hospital or intensive outpatient (IOP) services are often excluded.

Insurers publish a certificate of coverage which describes what mental health services are covered and what are excluded.