Wiki Substance Abuse Intensive Out Patient H0015 billing provider?

[stazispirit]

The situation is that there is a substance abuse facility that performs the three hour intensive outpatient treatment service that is billed under one code H0015. The three hour segments of the service are performed by three different therapists. They are all therapists, no one is an MD. There is no Incident To situation going on. There is no supervising therapist. The MD oversees ongoing care generally, with regular visits but is not present at the time of these services.

How is the billing provider determined?

​My knee jerk reaction is to draw straws and pick someone of the three to bill under, and after spending many hours now reading on this, I still don't have a better answer. Anyone have direction to an official answer on this, please let me know. ​

 

[Cavalier40]

Most insurances, the facility itself as the rendering provider. Some insurances like Magellan require the medical director to the the rendering on the UB.

 

[stazispirit]

thank you

Thanks for being my whisper of reason in the swirling cloud in my mind about this.

 

[jmiller3612]

What are your therapists? LCP? LAC?

Depending on your payor, you may need to know this. Check into the state regulations as to what is considered a Behavioral Health Professional. Here in AZ, any therapist that runs groups must be supervised by a BHP. The definitions of BHP can vary state to state I think.