Service Packages in NextGen® Enterprise PM

Practices may provide services to their patients or clients based on the various service packages authorized by payers. Each service package includes groupings of specific CPT4 code and modifier combinations with defined service unit limitations. A patient's authorized package services may be used within a specific time frame determined by the payer.

For example, in a Behavioral Health practice, a payer may authorize a patient for a package that includes the following services: Addiction counseling not to exceed 40 hours within 90 days; Individual therapy not to exceed 50 units within 180 days; Group therapy not to exceed 60 units within 180 days; Medication management not to exceed 70 hours within 180 days.

The service package functionality in NextGen® Enterprise PM enables you to do the following:

• Set up service packages with service unit and duration limitations.
• Enter service unit authorizations for payers that authorize packaged services for patients.
• Generate reports for patients with service unit authorizations.