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CAPC Palliative Care Discussion Forum
Palliative Care Out-Patient Services

Next Reply: Re:Outpatient Palliative Care Program Resources?
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Post Outpatient Palliative Care Program Resources?
Author: LindaCK
Date: Apr 21, 2010 10:56 am
We're considering expanding our IP palliative care program to the outpatient setting. Would appreciate any info on a business model, staffing and reimbursement. Under new healthcare reform, is a MD referral required for social work services for counseling and education? What outpatient diagnostic and billing codes are accepted by CMS and private insurance for PC? Thanks - Linda
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+ Re:Outpatient Palliative Care Program Resources? (by chambersn on 04/21/2010)
We also have a inpt PC program that has been very successful and are moving to develop an outpt model. I also have many questions related to SW billing. I am a LCSW and also have a private practice and do not want my billing all confused! I have questions about if CMS views discussion and education regarding goals of care as " psychotherapy " as that is what they typically remiburse SW's for. At one time I had talked to a CMS representative and understood that they viewed PC work as primarily case managment and would look very closely at whether it was clinical psychotherapy before approving it. I also have some concerns aobut how it might change things for patients who come in to see us for PC support and then are billed for mental health diagnosis and treatment. Would they be required to do a copay...would they still be willing to come see us? Who might know more about this? Any feedback would be really appreciated.

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