Wiki New CPT codes for psychiatric collaborative care services

[leramo]

Is anyone reporting G0502, G0503, or G0504 for psychiatric collaborative care? In 2018, these codes will become CPT codes 99492-99494. I'm looking for a primary care practice that performs these services and am interested in speaking with a physician for a story I'm writing that will appear in a major trade publication that targets independent providers. I'm also looking for coding consultants/experts who specialize in behavioral health. If you're interested in providing input for the story, please email me at leramo@hotmail.com.

Thank you!
Lisa Eramo
www.lisaeramo.com

 

[czaniewski]

new/old codes for psychiatric collaborative care denials

I have 2 practices (one Family Medicine and one Internal Medicine) that provide these services. The G0502 and G0503 codes were paid by Medicare when the billing provider was an MD and the rendering provider was an LPC. Medicare prefers that you bill each of these codes on 1 line with the total units for the month billed, rather than individual lines per visit. I have recently run into a problem with Medicare when the billing provider is an NP and the rendering provider is an LPC. They are denying as provider not eligible to provide this service. I have reviewed CMS MLNs for both years and it does not specify either code cannot be billed this way. In the description of the providers on page 2, it lists who can be billing provider and who can be Behavioral health care managers. Maybe I'm missing something but it does not clearly say that an NP cannot be the billing provider and the LPC cannot be the rendering provider at the same visit. I am looking for someone who has billed this way and has gotten paid. Is it different in each state? I am in South Carolina and I have been told to appeal the denial with documentation in order to get the claim reviewed. Anyone else having this problem?