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One of the most common questions we get is regarding what court-ordered services, if any, can be covered by insurance. I say “if any” because attorneys and clients sometimes have the mistaken assumption that mental health services cannot be covered by insurance when they are court-ordered.
However, it is not the referral source that determines whether a service could be reimbursed by insurance. Two criteria must exist for a service to be medically necessary, a relevant CPT code (i.e., service code) and diagnostic code. Or in plain English, if a client meets criteria for a mental health diagnosis that can be treated with therapy or medication, that claim can be turned into insurance.
So here’s the QUICK GLANCE for potential insurance reimbursement:
- Therapy – yes (includes all forms of therapy, for all presenting problems)
- Psychological (or substance abuse) Evaluation – yes
- Parent Coordinator – no
- Custody Evaluation – no
(Read on...)
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