Comparative Billing Reports

CBR201808 Statistical Debriefing

CBR201808

The following is a description of the tables used in CBR201808 Psychologists. There are links that will open the Excel files that contain state and national statistics used in the analysis of Part B rendering providers. The analyses in this Comparative Billing Report (CBR) include only the selected Current Procedural Terminology (CPT®) Codes listed in Table 1 below. CBR201808 is an analysis of claims with dates of service from April 1, 2017 to March 31, 2018 based on the latest version of claims available from the Integrated Data Repository as of July 9, 2018. Examples of each table can be found in the CBR201808 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

90792

Psychiatric diagnostic evaluation with medical services

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

90846

Family psychotherapy, 50 minutes

90847

Family psychotherapy including patient, 50 minutes

90853

Group psychotherapy

96101

Psychological testing with interpretation and report by psychologist or physician per hour

96102

Psychological testing with interpretation and report by technician per hour

96103

Psychological testing with interpretation and report by computer

96105

Assessment of expressive and receptive speech with interpretation and report per hour

96111

Developmental testing

96116

Neurobehavioral status examination, interpretation, and report by psychologist or physician per hour

96118

Neuropsychological testing, interpretation, and report by psychologist or physician per hour

96119

Neuropsychological testing by technician with interpretation and report by a qualified healthcare professional per hour

96120

Neuropsychological testing by a computer with interpretation and report by a qualified healthcare professional

96150

Health and behavior assessment each 15 minutes

96151

Health and behavior re-assessment each 15 minutes

96152

Health and behavior intervention, individual each 15 minutes

96153

Health and behavior intervention, group each 15 minutes

96154

Health and behavior intervention, family and patient each 15 minutes

* CPT® codes and descriptors are copyright 2017/2018 American Medical Association. All rights reserved. Applicable FARS/DFARS apply

 

Summary of Your Utilization

                                                                                   

Table 2 depicts the rendering provider’s utilization of the individual psychotherapy CPT® codes and a summary of all other codes from Table 1.

 

Table 2: Mock Data Summary of Your Utilization

Dates of Service: April 1, 2017 – March 31, 2018

CPT® Code

Allowed
Charges

Allowed
Services

Visits*

Beneficiary
Count

90832

$0

0

0

                    0

90834

$0

0

0

0

90837

$32,425

243

243

22

90839

$0

0

0

0

90840

$0

0

0

0

All Other

$1,105

8

8

8

Total

$33,530

251

251

25

       * 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 $33,530 for the CPT® codes included in the study and has provided 251 allowed services to 25 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. Each provider’s average is compared to his/her state and the nation using the t-test with an alpha value of 0.05. Table 3 is an example of the results of this analysis.

 

Table 3: Mock Average Minutes per Psychotherapy Visit

Dates of Service: April 1, 2017 – March 31, 2018

Number of    Minutes

Number of Psychotherapy Visits

Your Average

Your State’s Average

Comparison with Your State

National Average

Comparison with National Average

14,580

243

60.00

49.20

Significantly Higher

47.76

Significantly Higher

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

 

This mock provider has 14,580 minutes calculated from the number of services displayed in Table 2 for each of the individual psychotherapy codes. These minutes cover 243 psychotherapy visits. Dividing 14,580 by 243 visits yields the average minutes per psychotherapy visit of 60.00. 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 minutes per psychotherapy visit for each state and the nation, please select the following link: CBR201808 Average Minutes per Psychotherapy Visit.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 the t-test with an 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: April 1, 2017 – March 31, 2018

Number of Visits

Number of Beneficiaries

Your Average

Your State’s Average

Comparison with Your State

National
Average

Comparison with National Average

251

25

10.04

9.83

Higher

7.03

Significantly Higher

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

 

This mock provider has 251 visits for 25 beneficiaries. Dividing 251 by 25 beneficiaries yields the average number of visits per beneficiary of 10.04. In this case, the t-test does not confirm significance when this provider’s value is compared to the state; however, this provider’s value is significantly higher when compared to the nation.

 

To view the average number of visits per beneficiary for each state and the nation, please select the following link: CBR201808 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 the 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: April 1, 2017 – March 31, 2018

Charges

Number of Beneficiaries

Your Average

Your State’s Average

Comparison with Your State

National
Average

Comparison with National Average

$33,529.89

25

$1,341.20

$1,103.07

Higher

$776.60

Significantly Higher

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

 

This mock provider has $33,529.89 in allowed charges for the CPT® codes included in this CBR. This covers 25 beneficiaries. Dividing $33,529.89 by 25 beneficiaries yields the average allowed charges per beneficiary of $1,341.20. In this case, the t-test does not confirm significance when this provider’s value is compared to the state; however, this provider’s value is significantly higher when compared to the nation.

 

To view the average allowed charges per beneficiary for each state and the nation, please select the following link: CBR201808 Average Allowed Charges per Beneficiary.xls.