ADHD treatment benefits patients and pediatricians

ByRichard Lander, MD

Pediatricians are losing care of their patients to urgent care centers and retail-based clinics. We should not turn away the care of our patients if the problem can readily be treated by pediatricians. A perfect example is the diagnosis and treatment of attention-deficit/hyperactivity disorder.

Richard Lander

The evaluation and treatment of ADHD is taught during pediatric residencies, can be found in pediatric textbooks, and is covered at conferences and workshops. To diagnose your patient with ADHD, data must be obtained from two settings. Once the diagnosis is made, there are different treatment modalities to employ. Best practice should begin with an evaluation for medication. The ancillary symptoms can be addressed through educational and/or psychotherapy interventions. Our colleagues in education and child psychology can provide important services, but the choice of medication and when it is to be given falls to pediatricians to manage. Time spent with the patient and/or family for these discussions can be billed to the following codes:

99213: 15 minutes for an established patient;
99214: 25 minutes;
99215: 40 minutes; or
96110: review per screening tool such as a Connors or Vanderbilt.

It is not enough to evaluate your patient one time. It is considered good practice to have the patient return to the office 4 weeks after the correct dosage of medication is determined and then every 3 months to investigate potential side-effects, such as elevated blood pressure or weight loss. These visits are typically coded as 99212 for a 10-minute visit.

The financial benefit to the practice for all of these visits is dependent upon your payment schedule with the managed care organizations. The range should be between $250 to $350 per patient per year. For every 100 patients, this translates to additional revenues of $25,000 to $35,000 per year.

ADHD is merely one pediatric issue that can readily be treated by pediatricians. The financial benefits of treating your patients with ADHD are apparent. Most importantly, however, treating your patients with ADHD underscores the importance of maintaining your pediatric practice as your patient’s medical home.

— Richard Lander, MD, is a pediatrician in private practice in northern New Jersey and is a member of the Infectious Diseases in Children Editorial Board. He is co-chair of the Pediatric Initiative at the Atlantic Health Care System and clinical assistant professor of pediatrics at the University of Medicine and Dentistry of New Jersey in Newark, N.J.

Disclosure: Lander is co-owner of both the National Discount Vaccine Alliance, and Resources in Physician Management Services. He is also a speaker for Merck, Novartis, Pfizer and Sanofi-Pasteur.