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Cognitive behavioral therapy


Cognitive behavioral therapy is increasingly gaining traction across the workers compensation industry as a measure for helping injured employees return to productivity.

So if you are not familiar with CBT, a type of mental health counseling, you may want to learn at least enough to discuss it casually.

I'm increasingly hearing about its use as an alternative to prescribing addictive, narcotic pain medications known as opioids for workers suffering from chronic pain.

It's also used as a means for helping workers overcome other psychosocial issues that can cause claims to drag on unresolved.

If you care to learn more, Business Insurance recently published a story available here on how workers comp payers are increasingly backing the use of CBT.

Following the publication of that story, Michael Coupland, president of West Palm Beach, Fla.-based Integrated Medical Care Solutions connected to explain how provider billing for CBT services has become easier in recent years – which has also helped its use expand into workers comp.

Mr. Coupland should know. His company provides a network of 750 psychologists who provide CBT services for workers comp companies such as Broadspire the third party claims administrator.

Just a few years ago it was a challenge for psychologists to list CBT services on medical billing forms, Mr. Coupland explained.

“Psychologists, the only diagnosis s they could give traditionally were psychiatric so they would list major depressive disorder or adjustment disorder,” Mr. Coupland said. “It was typically an over diagnosis, but they had to do it in order to get paid and see the patient.”

But that began to change around 2003 when new health and behavior medical codes emerged making it easier to bill and receive payment for assessing and treating patients under a physical diagnosis rather than a mental health diagnosis.

The new codes essentially say the patient is receiving counseling to adhere to medical treatment for common ailments such as chronic pain or diabetes, Mr. Coupland said.

Since then there has been more buy in from workers comp payers because “we are not giving an unwarranted psych diagnosis,” he said.

Gradually, an increasing number of workers comp payers have begun to request CBT. Because billing for it is now for the original physical diagnosis so payers no longer have to fear they are buying a “second (psych) claim,” Mr. Coupland said.

Most of that buy in has come from self insured employers, Mr. Coupland added.