Coding/Billing for Case Management Services

[tholt77]

Hello Everyone,
We are looking at adding a case manager for our clinic. The primary focus of this position would be connecting our patients with external resources such as housing, food, transportation, etc. I think we can't get reimbursed for these services, but I wanted to ask all of you to make sure. Thank you in advance for taking the time to answer my question. It has been a long time since I billed Behavioral Health.
Tracy

 

[CBLENNIE]

This type of service is typically not covered by commercial insurance or Medicare, it would possibly be covered by Medicaid. If this service is covered by your state's Medicaid program, you need to check your provider resources for the program because they likely have specific coding requirements for this service.

 

[ckeeney]

This type of service is typically not covered by commercial insurance or Medicare, it would possibly be covered by Medicaid. If this service is covered by your state's Medicaid program, you need to check your provider resources for the program because they likely have specific coding requirements for this service.

I agree you should check with your state Medicaid program. I work for a community behavioral health center and we can only bill case management services to a specific Medicaid program in our state (Indiana). The code that they allow for this is T1016 with some modifiers specified in the manual for CBHC, face-to-face and non-face-to-face and one for a specific sub-category of eligibility. It bills in 15 minute units with allowing counting a unit for time that is at least 8 minutes.