Behavioral Health Visit Types

Visit Type	E&M Code
Case Consultation	90882
Developmental Testing - Extended	96112
Developmental Testing - Limited	96110
Family Consultation	99201-99215
General Medical Exam	99201-99125
Group Home Visit	95510
Home Visit	95510
Hospital Consult	99251-99255 or 99221-99223
Intake No Medical Service	90791
Intake with Medical Services	90792
Medication Management with Psychotherapy	99201-99215
Medication Management with Psychotherapy &Translator	99201-99215
Medication Management without Psychotherapy	99201-99215
Onsite Consult	99201-99215
Psychiatric Diagnostic Evaluation	90791
Psychiatric Evaluation with Medical Services	90792
Psychotherapy - Family without client	90846
Psychotherapy - Family & Client	90847
Psychotherapy - Family Group	90849
Psychotherapy - Group	90853
Psychotherapy - Individual with E&M	99201-99215

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Obstetric Visit Types

The Obstetric (OB) visit types are very specific to the unique requirements for billing OB and prenatal visits. Use the OB Prenatal - Initial visit type to confirm and document the beginning of a pregnancy where the prenatal record has not been initiated. You can bill for the encounter using the standard E&M codes 99201–99215. Note: Effective January 1, 2021, code 99201 will be deactivated. Use the OB Prenatal visit type for encounters where you are using the prenatal record. The application tracks each encounter during the current pregnancy with the OB Prenatal visit type on a hidden field on the Home page. You can bill prenatal visits separately if a patient obtains a new insurance plan or changes providers, and/or other complications arise. The Finalize template adds the number of prenatal encounters that have been documented for the current pregnancy and calculates the appropriate prenatal E&M code. For the OB Prenatal and OB Postpartum visit types, you can select the Prenatal/Post

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

New and Established Patients and Visit Types

There are many different E&M Service categories, such as Office Visits, Consultations, and Preventive Services. Most of these services are further categorized into New and Established patient services, where the calculation of E&M levels begins in NextGen® Adaptive Content Engine. To calculate an E&M code, you must select a New or Established patient designation along with a description from the Visit Type list. Most, but not all, visit types are mapped to E&M codes. This mapping is used in the overall calculation of the E&M code. For example, visit types classified as office services are mapped to sick E&M codes 99201-99215. Preventive medicine visit types are mapped to preventive medicine E&M codes 99381-99397. For more information about E&M mappings, go to NextGen Healthcare Success Community, and download the E&M Bullets and Field Mapping System Template for NextGen® Adaptive Content Engine. Note: NextGen Healthcare strongly recommends that you do not add or delete items from the S

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Behavioral Health Billing on the Finalize Template

The Finalize template calculates the Evaluation and Management (E&M) code and submits the code to the NextGen® Enterprise PM application. The Evaluation and Management Coding panel on the Finalize template calculates the E&M code based on the elements documented or the amount of time documented when more than 50% of the visit is spent counseling and/or coordinating care. The system fills the Visit Code field with the suggested Current Procedural Terminology ( CPT® ) codes. You should review the suggested CPT® code prior to submitting the code for billing. When the practice selects the 97 Coding Guidelines option on the Practice Configuration practice template and the specialty is set to Behavioral Health, the system defaults to the 97 Single System Psychiatric exam guidelines for the following visit types: Family Consultation General Medical Exam Hospital Consult Medication Management without Psychotherapy Onsite Consult Psychotherapy - Individual with E&M Medication Management with Ps

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Group Visit Workflows

There are several types of psychotherapy visits, of these, group visits are a common occurrence in the Behavioral Health setting. Family and group psychotherapy visits can only be completed for a client who is already designated as a member of a group in the system. Each of the following Visit Types has been configured with the following data to successfully integrate the Behavioral Health billing functionality with NextGen® Enterprise PM: Visit Type Licensure Associated Service Code Time Based Alert Family Consultation MD, DO, NP 99201-99215 based on elements documented or time Yes, when more than 50% of visit is spent counseling and/or coordinating care When the code cannot be calculated because there is large range of possible codes for that visit type, multiple codes are required, or the visit type is based on time Group Home Visit All 99510 No Psychotherapy - Group All 90853 No Psychotherapy - Family Group All 90849 No Note: Effective January 1, 2021, code 99201 has been deactivat

NextGen Behavioral Health Suite Help 5.6

Group Visit Workflows

Group visits are type of psychotherapy visit that are common in the behavioral health setting. Family and group psychotherapy visits can only be completed for a client who is already designated as a member of a group in the system. Each of the following Visit Types has been configured with the following data to successfully integrate the Behavioral Health billing functionality with NextGen® Enterprise PM: Visit Type Licensure Associated Service Code Time Based Alert Family Consultation MD, DO, NP 99201-99215 based on elements documented or time Yes, when more than 50% of visit is spent counseling and/or coordinating care When the code cannot be calculated because there is large range of possible codes for that visit type, multiple codes are required, or the visit type is based on time Group Home Visit All 99510 No Psychotherapy - Group All 90853 No Psychotherapy - Family Group All 90849 No Note: Effective January 1, 2021, code 99201 is deactivated and cannot be selected. Verify the Pre

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Group Visits for Behavioral Health

There are several types of psychotherapy visits, of these, group visits are a common occurrence in the Behavioral Health setting. Family and group psychotherapy visits can only be completed for a client who is already designated as a member of a group in the system. The following Visit Types are associated with group visits: Family Consultation Group Home Visit Psychotherapy - Group Psychotherapy - Family Access the Group Therapy Progress Note Document Program Name for Groups Enter Group Information Record the Individual’s General Group Participation Record New Issues Enter Goals, Objectives, and Interventions Addressed Today Document Plan and Additional Information Enter Assessment and Diagnosis Details Record Signatures on the Group Therapy Progress Note Complete Behavioral Health Billing Parent topic: Group Visit Workflows

Behavioral Health Visit Types

Recommendations

Obstetric Visit Types

New and Established Patients and Visit Types

Behavioral Health Billing on the Finalize Template

Group Visit Workflows

Group Visit Workflows

Group Visits for Behavioral Health

Behavioral Health Visit Types

Obstetric Visit Types

New and Established Patients and Visit Types

Behavioral Health Billing on the Finalize Template

Group Visit Workflows

Group Visit Workflows

Group Visits for Behavioral Health