An Exploration of Behavioral Health Productivity and Billing Practices Within Pediatric Primary Care

J Pediatr Psychol. 2016 Nov;41(10):1133-1143. doi: 10.1093/jpepsy/jsw063. Epub 2016 Aug 7.

Abstract

OBJECTIVES : To provide descriptive information on behavioral health (BH) productivity and billing practices within a pediatric primary care setting. METHODS : This retrospective investigation reviewed 30 months of electronic medical records and financial data. RESULTS : The percent of BH provider time spent in direct patient care (productivity) was 35.28% overall, with a slightly higher quarterly average (M = 36.42%; SD = 6.46%). In the 646.75 hr BH providers spent in the primary care setting, $52,050.00 was charged for BH services delivered ($80.48 hourly average). CONCLUSIONS : BH productivity and billing within pediatric primary care were suboptimal and likely multifactorially derived. To promote integrated primary care sustainability, the authors recommend three future aims: improve BH productivity, demonstrate the value-added contributions of BH services within primary care, and advocate for BH-supporting health care reform.

Keywords: adolescents; children; health care services; primary care.

MeSH terms

  • Adolescent
  • Adolescent Health Services / organization & administration*
  • Child
  • Child Health Services / organization & administration*
  • Child, Preschool
  • Community Mental Health Services / organization & administration*
  • Efficiency, Organizational / statistics & numerical data*
  • Fees and Charges / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Mental Disorders* / diagnosis
  • Mental Disorders* / economics
  • Mental Disorders* / therapy
  • Primary Health Care / organization & administration*
  • Retrospective Studies
  • United States