HELPING PROVIDERS PAY FOR DIRECT

Most Behavioral Health and Substance Abuse Professionals were not eligible for incentives to assist them in adopting electronic health records (EHRs) or other mechanisms to exchange health information. Yet we know how crucial this information is to having a fully developed understanding of an individual's needs. DIRECT is a less expensive option that will allow providers to exchange information safely and securely. But even though the costs are lower than acquiring an EHR, it can still be burdensome to some practices. MNBHN hopes to bring legislation that would require third-party payers to reimburse at a higher rate for individuals who certify that they have a DIRECT address. Some incentives are necessary to move the community forward to ensure widespread adoption of DIRECT.

We will ask payers to increase reimbursement for only one CPT code, 90791, the Diagnostic Assessment (DA). This is a service that individuals use usually once a year, and it results in the key summary of relevant information and recommendations for care. We are hopeful that payers will see the business case in increasing reimbursement by a small amount for this crucial service. If providers have a DIRECT address, it is more likely that they will share some or all of the information captured in the DA with other caregivers. This is likely to improve the accuracy of information all providers have, and result in improved care for individuals. 

If you are part of a professional association, please consider supporting MNBHN's legislative efforts to help defray the costs of DIRECT for Behavioral Health and Substance Abuse providers.