Wiki Billing 96152

[tbaethke]

We are an FQHC in Arizona. We have an LCSW. We need to bill 9615x codes but keep getting denied saying a modifier is missing.
Example:

T1015 FQHC Visit
96152 Health and Behavioral intervention, each 15 minutes, face-to-face, individual


Anyone know what modifier we would use?
Thanks,
Theresa Baethke
Circle the City

 

[bquin]

I am also an FQHC in Arizona and am having the same problem. Did you ever get or find the answer? thank you

 

[jliving77]

billing 9615x

Hello all, I am not sure why you are having a problem with getting reimbursed from AHCCCS for this code. I have no problems and I don't use a modifier. Are you billing with a medical dx primary? Is your provider contracted with all plans? We found out recently that there was a problem with one of our providers and the Advantage plan, UHC of course. The only time I have used a modifier, 25, is when the pt had another appt with us the same day. It doesn't get paid but it is picked up in the PPS recon. Sorry if this doesn't help, but it doesn't make sense to me either why AHCCCS would deny for a modifier for you all, but pay us.

Jennifer Livingston CPC
St. Elizabeth's Health Center