Q: What companies do you recommend for malpractice insurance?
A: We have designed our collaborative-care model for Journey Clinical to take on the medical aspect of KAP and for you to take on the psychotherapy aspect of the treatment.
Here are the most common companies that we see our members using. We recommend the top two as we’ve heard that that they're most supportive:
- American Professional Agency
- NASW (only for social workers)
- HPSO
- Allied World Insurance Company
- Acord
- Berxi
- Trust Risk Management Services
In the Journey Clinical Member Portal, we have drafted KAP Scope of Practice Talking Points and recorded a webinar on the topic. We recommend that you go to the Resources page within the Member Portal and review the Scope of Practice Talking Points document. That will be a helpful resource as you navigate conversations with insurance companies as it lays out very clearly how your scope of practice is not changing in this work.
The following three topics are located in your member portal under "Resources":
- KAP scope of practice talking points
- A webinar on "Navigating Scope of Practice for KAP (with Journey Clinical, Fluence, Lauren Taus & Bruce Hillowe)
- A KAP-specific informed consent form for your clients
Q: How do you code dosing sessions for insurance?
A: The first hour of the three-hour-long ketamine session is the same as holding a regular 60-minute psychotherapy session.
Since KAP preparation + integration sessions are regular therapy sessions, they should be covered by insurance. Members typically code preparation + integration as regular psychotherapy, using code 90837
- The add-on/prolonged service code still active is 99417 (for 15 min of service)
- Members can also bill for interactive complexity (e.g., curating playlists, following blood pressure and swishing protocols) using code 90785
- You can read more about Superbills and access a sample HERE.
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Here are some helpful links that we love to share with our members that cover the topics of ICD-10 codes and add-on codes for KAP sessions:
- Osmind CPT
- A New Way to Bill for Extended Sessions by Barbara Griswold, LMFT
- Here are the ICD-10 codes that our prescribers are using for the consultation sessions with the patients:
Intake (60 minutes) with a prescription: 90792
Intake (60 minutes) without a prescription:90791
Follow-up (30 minutes) with a prescription 99214
We hope that this information will serve as a guide in order to help you make the best decision.
Q: How can my client use their insurance for their treatment?
A: Journey Clinical is out-of-network with all insurance companies, however we can supply clients with a Superbill for their consultation to submit as a claim to their health insurance company for reimbursement. We ask patients to first call the member services number on the back of their health insurance card to find out if they will accept and cover the below CPT codes for our consultations. If they agree to cover the consultation, then the client may request a Superbill from us to submit to their insurance for reimbursement.