Member Resources

What Psychiatrists Need to Know Archives

Each issue of the NCPA News print newsletter features a column, "What Psychiatrists Need to Know About..." The subject matter changes based on important updates and member concerns or questions. See all the archived columns here.

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NC Medicaid Transformation

NC Medicaid Managed Care Transformation efforts have been restarted. Standard Plans went live July 1, 2021, while Behavioral Health I/DD Tailored Plans are scheduled to launch on December 1, 2022 instead of July 1, 2022. 

Background:

In 2015, the NC General Assembly directed the transition of Medicaid to a privatized managed care structure. For the first time in NC Medicaid history, we will have an integration of behavioral health and physical health reimbursement dollars. In February 2019, NC DHHS announced the four entities who have received contracts to participate as Prepaid Health Plans (PHPs) in Medicaid Managed Care:

  1. AmeriHealth Caritas North Carolina, Inc.
  2. Blue Cross and Blue Shield of North Carolina
  3. UnitedHealthcare of North Carolina, Inc.
  4. WellCare of North Carolina, Inc.

A regional contract for Regions 3 and 5 was awarded to Carolina Complete Health, Inc.

Quicklinks to Plan Resources:

NC DHHS | AmeriHealth Caritas | Carolina Complete Health | Healthy Blue | United Healthcare | WellCare

Please note, this procurement is for the Standard Plans, in which 1.6 million Medicaid Managed Care beneficiaries will be enrolled. Tailored Plans, designed for certain populations with more specialized behavioral health needs, will be procured later. Psychiatrists can and should enroll with both the Standard Plans and Tailored Plans.

See Medicaid Transformation Resources>>
 

Integrated Care

Over the past decade, the integration of behavioral health and general medical services has been shown to improve patient outcomes, save money, and reduce stigma related to mental health. Significant research spanning three decades has identified one model – the Collaborative Care Model – in particular, as being effective and efficient in delivering integrated care.

See Integrated Care Resources>>
 

Seclusion and Restraint

Seclusion and Restraint Resources>>
 

A Psychiatrist’s Toolkit: Supervising NPs and PAs

Nurse Practitioners and Physician Assistants (NP/PA) have long played an important role in the provision of healthcare in North Carolina. NP/PAs have worked with psychiatrists in every practice setting—private practice, institutions, and particularly community mental health agencies. The traditional multi-disciplinary team approach of psychiatric care has instilled an appreciation for and reliance upon all clinicians in the care of this complex patient population, making the field uniquely situated to embrace the evolving health care delivery system of team-based care, collaborative care, accountable care, and shared savings. To that end, psychiatry’s ability to work with other professionals, to assess skills, and to assist in their development will be even more crucial.

See Supervising NPs and PAs Toolkit>>
 

CPT Coding, DSM-5, & ICD-10 Information

The last few years have brought major changes to the way psychiatrists diagnose, code and bill for their patients' treatment. 

DSM-5 Resources

ICD-10 Resources

The 2021 release of ICD-10CM Includes new, updated or deleted codes for medical conditions. A handful of these changes pertain to medical disorders that go into effect October 1, 2021.Download a quick-reference guide to the changes

The CDC has updated the ICD-10-CM with 11 new diagnosis codes describing social determinants of health. These new Z codes were created to provide additional information regarding data such as housing, food insecurity, or transportation. 

View the Changes Here

 

CPT Coding

 
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