Wiki Medicaid and Observation codes - are they paying??

[Missy13]

Would anybody be able to tell me if Medicaid is paying for observation codes?
Initial
99218
99219
99220
Subsequent
99224
99225
99226
and discharge code 99217

Medicaid and others, like Molina, UHCCP, Meridian...
I called them to find out but they are not being that helpfull.

Thanks much!

 

[AmandaW]

They should be paying for the initial observation codes but not subsequent as per the 24 hour rule. On that second day they are automatically billed as inpatient due to this rule. The 99217 would be billed as 99238.

 

[dclark7]

What state are you in? Have you checked your Medicaid fee schedule? Most states have a website where you can look up policies and coverage, I've found the websites to be more informative than calling.