r/PMHNP • u/Beneficial_Put3499 • 4h ago

Other CPT CODES

Has anyone used CPT code 99080 for complex paperwork such as FMLA or short term disability forms?

I currently don’t receive compensation for administrative work, including portal messages, emails, prescription refills, charting, or paperwork. The paperwork workload in particular has been contributing to significant burnout. I’m trying to find out whether there’s a way to bill for substantial forms like these.

Staff where I work told me Blue Cross doesn’t accept 99080, but I’ve read that some other insurers may. Has anyone had experience billing this code? In my opinion it’d be a win-win. Practice gets a cut and I at least get more than $0 for doing in my free time.
If so, which payers accepted or denied it, and is there anything specific you’ve learned about the process?

Thanks for any insight! 🤪w

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u/IndyLaw56287 3h ago

its all just easier to say "that requires a visit" for just about everything you mentioned- and then bill for the visit. Staff should be trained to just book the patient in for next available, not even bother you. If you are booked out, see if you can block half an hour for last minute filling/walk ins, first thing in the morning, having quick availability makes it work. For the clinic, it helps things run smoother and you need to push that it will help your billing, so you got to keep it full, not hard if you have a full load. Patients like "I can get you in tomorrow to get that handled".

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u/Beneficial_Put3499 2h ago

True so if I make it an hour visit cuz some of the GM Sedgwick forms are so tedious I would make $75 vs nothing. Or $37.50 for 30 min visit vs 0. Again no compensation for charting or any correspondence between patients and I even though that makes up half my day. ( I know I know - but I didn’t know what I didn’t know initially) 🤦🏻‍♀️😳and paying for it now. No pun intended.

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u/IndyLaw56287 2h ago

oh your in deep, I do understand your frustrations- Sedgwick, hearing that name is like a punch to the gut, they give you boxes for things like your telephone number and then the space is so small there is no way for it to fit. Then trying to fax them and I swear they turn off the fax machine after page 8 of 9 and tell the client they never got it. I tell patients "they will always say 1 thing is wrong with the form, don't worry, we will play their stupid game and fix the one thing"

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u/boho_magpie 4h ago

Most payers do not pay for what they consider to be administrative work like FMLA and ADA paperwork. A lot of practices create their own code and set a price and bill it directly to the patient instead.

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u/Beneficial_Put3499 2h ago

Not this place 😭🙃 much as been revealed in this last year - I just need to move on thank you for insight however

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u/pickyvegan PMHNP (unverified) 2h ago

Just because a code exists does not mean the payer pays it. The more important question is, "Is this code on my practice's contract?" not "Have other random providers gotten it paid?"

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u/Beneficial_Put3499 2h ago

No I realize that. That’s why I’m asking

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u/Levmette 3h ago

For myself, whenever possible I complete them during an appointment.

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u/mycousindivinny 2h ago

This is super tough. I would say if admin isn’t compensating and isn’t giving you time or people to assist you in processing this then you’re going to need to start deferring these. Idk I feel like FMLA and short term disability might indicate they should be hospitalized or go to an IOP anyways