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HomeMy WebLinkAboutAgenda 06-03-2025; 8-u - Approval of Health Department Fee Changes 1 ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: June 3, 2025 Action Agenda Item No. 8-u SUBJECT: Approval of Health Department Fee Changes DEPARTMENT: Health Department ATTACHMENT(S): INFORMATION CONTACT: Attachment 1. Proposed Fee Changes Quintana Stewart, 919-245-2412 Frederick Perschau, 919-245-2414 PURPOSE: To approve changes to the Personal Health Services fee schedule as recommended by the Board of Health and amend the FY 2024-25 County Fee Schedule. BACKGROUND: Personal Health Services within the Orange County Health Department has requested seven (7) new fees for Behavioral Health and Nutrition Services. Staff proposes adding one (1) code for preventive medicine counseling that can be used for individual counseling on diabetes risk reduction and disease prevention. Personal Health Services' staff also propose to add/update six (6) fees to be used for behavioral health services when the Department begins billing for Integrative Behavioral Health in July 2025. Information on the one (1) preventative medicine code and the six (6) Behavioral Health codes can be found on the attached fee schedule proposal. Health Equity Impact These preventive medicine and psychotherapy counseling fees will allow us to bill at the Medicaid reimbursement rate thus keeping the cost low for self-pay patients on the sliding fee scale. FINANCIAL IMPACT: The adoption of these fees may result in additional revenue in FY 2025- 26. Staff will review during the fiscal year. ALIGNMENT WITH STRATEGIC PLAN: This item supports: • GOAL 2: HEALTHY COMMUNITY OBJECTIVE 2. Expand access to quality, affordable healthcare services. (e.g., Crisis Diversion facility, Medicaid expansion, crisis response, healthy living campaign) RECOMMENDATION(S): The Manager recommends that the Board approve the fee updates as recommended by the Board of Health. 2 FY 2025-26 Annual Operating Budget Proposed Fee Change Department HEALTH-PH List any proposed new fees or fee changes below Reason for Increase (Describe, in detail,why the increase 2025-26 is needed and what impact the 2024-25 Proposed Effective Division Name of Fee increase will have.) Rate Rate Date New Fee- LCSW to begin billing for 90785-Interactive Complexity(add-on Integrated Behavioral Health services Personal Health Services code for psychiatric services) beginning July 2025 New* $ 45.17 July 1, 2025 New Fee- LCSW to begin billing for 90791 -Integrated Biopsychosocial Integrated Behavioral Health services Personal Health Services Assessment beginning July 2025 New* $ 206.16 July 1, 2025 New Fee- LCSW to begin billing for Integrated Behavioral Health services Personal Health Services 90832-Psychotherapy,30 min beginning July 2025 New* $ 74.01 July 1, 2025 New Fee- LCSW to begin billing for Integrated Behavioral Health services Personal Health Services 90834-Psychotherapy,45 min beginning July 2025 New* $ 97.83 July 1, 2025 90846-Psychotherapy,family w/o Fee decrease because Medicaid Personal Health Services patient Reimbursement rate has decreased $ 95.00 $ 94.08 July 1, 2025 90847-Psychotherapy,family with Fee decrease because Medicaid Personal Health Services patient Reimbursement rate has decreased $ 115.00 $ 98.10 July 1, 2025 New fee need for Licensed Dietitian 99403-Preventive Medicine Nutritionists to bill Medicaid and Personal Health Services lCounseling,45 min Medicare for nutrition counseling. New* 1 $ 70.00 1 July 1, 2025