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Wiki SUD OP billing

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KSchrader

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New Smyrna Beach, FL
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Please help...

We have started doing family therapy and education groups at our facility but the insurance companies don't want to pay for both H0026 & 90846 in the same day. Does anyone have any suggestions for how else we can bill these?

Also for billing 90853 does anyone know what type of license a provider has to have? I have been billing under a MA LCDC for the past 3 years and had no problems up toil now 2020 they are stating her license doesn't fit the description for a billing provider for this service. Any help???
 
Who is the target audience for H0026 and for 90846? And who are your payers - is it a payer that has H0026 on their fee schedule? Is it a payer that allows services without the patient?

90853 - You will need to check with each payer. There is no specific license that is applicable to all payers. Is there a more specific code than the 90853 that describes what she is doing?
 
The patient's (client's) families are the target audience and they get family groups and education 1 weekend a month at our facility. Usual payers are BCBS TX, UBH, Aetna& Cigna, they all are codes (without patient present).

Thank you and I will look into each payer regarding the 90853
 
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