Comparative Billing Reports

CBR201807 Statistical Debriefing

CBR201807

The following is a description of the tables used in CBR201807 Licensed Clinical Social Workers. There are links that will open the excel files that contain state and national statistics used in the analysis of rendering Part B providers for CBR201807. The analyses in this Comparative Billing Report (CBR) include only the selected Current Procedural Terminology (CPT®) Codes listed in Table 1 below. CBR201807 includes claims with dates of service from January 1, 2017 to December 31, 2017.  These analyses are based on the latest version of claims available from the Integrated Data Repository as of May 15, 2018. Examples of each table can be found in the CBR201807 sample.

 

 CPT® Codes and Abbreviated Descriptions

 

Table 1 provides abbreviated descriptions of the CPT® codes included in this CBR.

 

Table 1: CPT® Codes and Abbreviated Descriptions

CPT® Code 

                Abbreviated Description

90785

Interactive complexity

90791

Psychiatric diagnostic evaluation

90832

Psychotherapy, 30 minutes

90834

Psychotherapy, 45 minutes

90837

Psychotherapy, 60 minutes

90839

Psychotherapy for crisis, first 60 minutes

90840

Psychotherapy for crisis, each additional 30 minutes

90845

Psychoanalysis

90846

Family psychotherapy, 50 minutes

90847

Family psychotherapy including patient, 50 minutes

90853

Group psychotherapy

 

Summary of Your Utilization

Table 2 provides a summary of your utilization for the CPT® codes included in this CBR.

 

Table 2: Mock Data Summary of Your Utilization

Dates of Service: January 1, 2017 – December 31, 2017

 

CPT® Code

Allowed

Charges

Allowed

Services

Visits*

Beneficiary Count

90785

$0

0

0

0

90791

$2,426

24

24

24

90832

$442

9

9

4

90834

$28,435

435

435

33

90837

$8,567

87

87

26

90839

$0

0

0

0

90840

$0

0

0

0

90845

$0

0

0

0

90846

$0

0

0

0

90847

$741

9

9

5

90853

$0

0

0

0

Total

$40,611

564

564

40

        * A visit is defined as a unique date of service between a beneficiary and a provider.

 

For this mock provider, the table indicates that he/she has total allowed charges of $40,611 for the CPT® codes included in the study.  This mock provider has provided 564 allowed services to 40 beneficiaries.

 

Please note that the totals may not be equal to the sum of the rows due to rounding. Also, the visit and beneficiary counts are unduplicated counts for each row and the total. For example, a beneficiary receiving multiple services with different CPT® codes within this time period would be counted in the beneficiary count in each applicable row; however, this beneficiary would be counted only once in the total row.

 

Average Minutes per Psychotherapy Visit

 

Table 3 presents the average minutes per individual psychotherapy visit. This metric is based on the typical visit times for CPT® codes 90832, 90834, 90837, 90839, and 90840. The average is calculated as follows:

 

  

 

To calculate the total number of minutes, the typical times from Table 1 are multiplied by the number services for each CPT® code from Table 2. Each provider’s average is compared to his/her state and the nation using t-test at the alpha value of 0.05. Table 3 below is an example of the results of this analysis.

 

Table 3:  Mock Average Minutes per Psychotherapy Visit

Dates of Service: January 1, 2017 – December 31, 2017

Number of          Minutes

Number of Psychotherapy Visits

Your Average

Your State’s Average

Comparison with

Your State

National

Average

Comparison with National Average

25,065

564

44.44

55.75

Does Not Exceed

49.86

Does Not Exceed

A t-test was used in this analysis, alpha = 0.05. 

 

This mock provider has 25,065 minutes calculated from the number of services displayed in Table 2 for each of the individual psychotherapy codes.  These minutes cover 564 psychotherapy visits. Dividing 25,065 by 564 visits yields the average minutes per psychotherapy visit of 44.44. The t-test indicates that this mock provider’s average “Does Not Exceed” those of either the state or the nation.

 

To view the average minutes per psychotherapy visit for each state and the nation, please select the following link: CBR201805 Average Minutes per Psychotherapy Visits.xls.

 

Average Number of Visits per Beneficiary

 

Table 4 shows the average number of service dates, or visits per beneficiary for the one-year period, using the CPT® codes listed in Table 1. This average is calculated as follows:

 

 

Each provider’s average is compared to his/her state and the nation using t-test at the alpha value of 0.05. Table 4 below is an example of the results of this analysis.

 

 

Table 4: Mock Average Number of Visits per Beneficiary

Dates of Service: January 1, 2017 – December 31, 2017

Number of Visits

Number of Beneficiaries

Your Average

Your State’s Average

Comparison with Your State

National

Average

Comparison with National Average

564

40

14.10

10.89

Significantly Higher

9.75

Significantly Higher

A t-test was used in this analysis, alpha = 0.05.

 

This mock provider has 564 visits for 40 beneficiaries.  Dividing 564 by 40 beneficiaries yields the average number of visits per beneficiary of 14.10. The t-test indicates that this mock provider’s average is “Significantly Higher” than those of both the state and the nation.

 

To view the average number of visits per beneficiary for each state and the nation, please select the following link: CBR201807 Average Number of Visits per Beneficiary.xls.

 

Average Allowed Charges per Beneficiary

 

Table 5 provides a statistical analysis of the average allowed charges per beneficiary. The average is calculated as follows:

 

  

 

Each provider’s average is compared to his/her state and the nation using t-test at the alpha value of 0.05. Table 5 below is an example of the results of this analysis.

 

             Table 5: Mock Average Allowed Charges per Beneficiary

Dates of Service: January 1, 2017 – December 31, 2017

Charges

Number of Beneficiaries

Your Average

Your State’s Average

Comparison with

Your State

National

Average

Comparison with National Average

$40,611.09

40

$1,015.28

$956.74

Higher

$724.38

Significantly Higher

A t-test was used in this analysis, alpha = 0.05. 

 

This mock provider has $40,611.09 in allowed charges for the CPT® codes included in this CBR.  This covers 40 beneficiaries.  Dividing $40,611.09 by 40 beneficiaries yields this mock provider’s average allowed charges per beneficiary of $1,015.28. The t-test indicates that this mock provider’s average is higher than both peer groups; however, only “Significantly Higher” than the national average.

 

To view the average allowed charges per beneficiary for each state and the nation, please select the following link: CBR201807 Average Allowed Charges per Beneficiary.xls.