If you would like to file for out-of-network reimbursement from your health insurance plan, you may need the following information along with a paid invoice including a diagnostic (ICD) and procedure (CPT) code for each appointment; please check your policy for more information, and be sure to ask us to include the ICD/CPT information on each session’s invoice. Blue Cross families, please see note below.
IF FILING FOR SERVICES PROVIDED BY DR. MCGINNIS:
Practice Name: McGinnis Behavioral
Tax ID (EIN): 81-3882367
Clinician: John C. McGinnis, PhD, Licensed Psychologist
Florida Psychology License No.: PY6149
Individual Clinician National Provider Identifier (NPI) No.: 1417028408
Organizational NPI No.: 1942715115
General Description of Services: “office- and telehealth-based outpatient behavioral services”
Practice Address: Three Palms Center, 2141 S. Alternate A1A, Suite 330, Jupiter, Florida 33477
Phone: (561) 295-4248
Fax: (561) 250-6832
Most likely procedure codes (“CPTs”; these are offered here in case you would like to investigate out-of-network reimbursement rates before commencing services): 90791 (Intake), 90846 (Family Therapy without Patient), and 90847 (Family Therapy with Patient)
IF FILING FOR SERVICES PROVIDED BY CARA SHAPIRO:
Practice Name: McGinnis Behavioral
Tax ID (EIN): 81-3882367
Clinician: Cara L. Shapiro, MS, BCBA, Behavior Analyst
Board Certified Behavior Analyst (BCBA) No.: 1-23-68819
Individual Clinician National Provider Identifier (NPI) No.: 1235708405
Organizational NPI No.: 1942715115
General Description of Services: “home- and telehealth-based outpatient behavioral services”
Practice Address: Three Palms Center, 2141 S. Alternate A1A, Suite 330, Jupiter, Florida 33477
Phone: (561) 295-4248
Fax: (561) 250-6832
Most likely procedure codes (“CPTs”; these are offered here in case you would like to investigate out-of-network reimbursement rates before commencing services): 97151 (Behavior Identification Assessment; 15-minute units), and 97156 (Family Adaptive Behavior Treatment Guidance; 15-minute units)
ATTENTION BLUE CROSS (BCBS) CLIENTS: We have discovered BCBS sometimes retrieves the wrong Tax ID from their internal database by using the NPI to retrieve it, even though the correct one is found on the paid invoice you share with them. Their database evidently continues to associate his NPI with a Tax ID that is no longer valid for him. Dr. McGinnis has attempted for years to correct this with them to no avail. If you are seeking out-of-network reimbursement from BCBS, be sure to tell a representative, “If you retrieve Dr. McGinnis’s Tax ID using his NPI, you may get the wrong one because your database is not current. The NPI is correct, and the Tax ID on the invoice is correct.” Feel free to share this page with them.