Clinical Social Work/Psychotherapy billing codes

[megans.lcsw]

Hi...I'm really hoping someone can help me out.  I am a Clinical Social Worker providing psychotherapy services to residents of group homes/assisted living facilities, etc.  The powers that be decided against hiring a billing company with part B expertise and instead are using the company that bills their part A work.  We are having a hard time identifying correct codes.  I thought that 90801, 90804, 90806, 90808, etc were the correct codes.  Am I wrong?  have they changed recently?  PLEASE help.  Any assistance is appreciated!

[bobbie]

When you refer to 'part B' are you billing specifically Medicare?  Are you using the AJ modifier? (90806AJ)

[megans.lcsw]

Yes...specifically and only Medicare.  I don't know that they are using the AJ modifier.  Is this referencing the location or provider (CSW as opposed to Psychologist, etc.)?  Thanks so much!!

[rdmoore2003]

I BILL 90801, 90806, ETC TO MEDICARE.  I DO NOT HAVE PROBLEMS WITH IT.   HOW ARE YOU LISTED WITH MEDICARE? DID YOU DO YOUR PECOS APP?  I THINK MAYBE THAT IF YOUR BILLING COMPANY IS SET UP FOR PART A ONLY....THAT WOULD BE YOUR ISSUE. 

[Michele]

There are also the 90816 & 90818 which are like the 90804 and 90806 but for facility settings.  Maybe that is what they are looking for (the billing company)?  But as a billing company they should have explained to you what it is they were looking for and not be sending you on a goose chase.  JMO