California Behavioral Medicine Provider Agrees

CA 2015 Behavioral Health
OIG False Claims
Penalty
$2.8 million

Outcome

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Details

California Behavioral Medicine Provider Agrees — $2,750,000 Settlement

Outcome: Official websites use .gov A .gov website belongs to an official government organization in the United States.

Official websites use .gov A .gov website belongs to an official government organization in the United States.

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SAN FRANCISCO – American Psychiatric Centers, Inc., doing business under the name Comprehensive Psychiatric Services (CPS), has agreed to pay $2.75 million to resolve allegations that CPS violated the False Claims Act by submitting false claims to government healthcare payors for certain psychotherapy services. CPS, which is headquartered in Walnut Creek, Calif., provides behavioral medicine services for individuals and families in the State of California. Since at least 2015, CPS and its healthcare providers have submitted claims to government payors using Current Procedural Terminology codes 90833 and 90836, which are “add-on” codes to be used when psychotherapy services are performed in conjunction with an evaluation and management visit, and which require specific documentation.

HHS Office of Inspector General

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Crucible's billing compliance controls enforce documentation-to-claims reconciliation, requiring clinical attestation before claims submission and flagging billing patterns that deviate from documented care delivery.

Source: California Behavioral Medicine Provider Agrees To Pay $2.75 Million To Resolve Alleged False Claims For Psychotherapy Services

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