ajvanekeren
New
CMS states: "There are a range of services described by existing coding under the PFS that can be billed for treatment of mental health conditions, including SUDs, such as individual, group, and family psychotherapy. Over the past several years, in collaboration with interested parties and the public, we have increased the coding and payment mechanisms for substance use treatment services paid under the PFS. For example, in the CY 2020 PFS final rule (84 FR 62673), we finalized the creation of new coding and payment describing a bundled episode of care for the treatment of Opioid Use Disorder (OUD) (HCPCS codes G2086–G2088). In the CY 2021 PFS final rule, we finalized expanding the bundled payments described by HCPCS codes G2086–G2088 to be inclusive of all SUDs (85 FR 84642 and 84643)."
This is from: Federal Register / Vol. 87, No. 222 / Friday, November 18, 2022
So if this has been known and understood since the 2021 final rule was published, why does the 2023 HCPCS Level II Book state these three codes (G2086, G2087, G2088) are ONLY for opioid use disorder when that is plainly not true? Based on the language from CMS, it can be used for alcohol and stimulant use disorders as well. Why was the code descriptor not updated? Am I missing something?
Any insight is appreciated! Trying to get to the bottom of how and when we can bill these codes.
This is from: Federal Register / Vol. 87, No. 222 / Friday, November 18, 2022
So if this has been known and understood since the 2021 final rule was published, why does the 2023 HCPCS Level II Book state these three codes (G2086, G2087, G2088) are ONLY for opioid use disorder when that is plainly not true? Based on the language from CMS, it can be used for alcohol and stimulant use disorders as well. Why was the code descriptor not updated? Am I missing something?
Any insight is appreciated! Trying to get to the bottom of how and when we can bill these codes.