Billing > Facility Billing

Substance Abuse PHP with housing

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Adxenes480:
I hope someone can help answer my question. I am billing for PHP services and the facility is licensed as day/night treatment with community housing. Reimbursement from some payers is very low. Are facilities that provide housing, meals, transportation, medication management AND the therapy reimbursed at the same rate as facilities that ONLY provide therapy and the patients live independently?? We’ve had claims pay as little as $159 per day. Is there something that we are are doing wrong? Can we bill for room and board?

Michele:
What rev code and/or HPCPs code are you billing?  Usually insurances have set fee schedules they pay based on the rev/HCPCs code.

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