The Workers’ Compensation Research Institute (WCRI) published a study on the use and billing of behavioral health support services in New York.
The data used comes from WCRI’s Detailed Benchmark/Evaluation (DBE) database. The analysis focused on non-COVID-19 claims with more than seven days of lost time, primarily for 2020 claims with 24 months of experience.
About 3% of indemnity claims had services billed under the codes included for behavioral health. Behavioral health services billed under codes included in the behavioral health fee schedule represented 8% of total medical payments
Among claims with behavioral health services, 45% had both assessments and treatments, while 40% had assessments only, and 16% had treatments only.
The most commonly billed codes based on payments were for psychotherapy, neuropsychological testing, and psychological testing. The most commonly billed codes based on frequency were for psychiatric diagnostic evaluations and psychological testing.
On average, it took approximately five months for workers to receive behavioral health services from the date of injury or disability.
Neurologic spine pain injuries accounted for the largest share of claims with behavioral health services, at about 41%.
Billing of behavioral health services was clustered in the New York City area, with about 72% of services, versus 28% of services billed in other areas of the state, or outside the state.
