Medical Billing Forum

Payments => Insurance Payments => : barb2512 August 14, 2014, 02:23:01 PM

: Pay Rate for H&B codes
: barb2512 August 14, 2014, 02:23:01 PM
Does anyone currently bill the following codes for a LPC?
96152
96154
96155

The counselor I work for is wondering what the reimbursement rate is for these codes. I have called Cigna, UBH and CareFirst. They tell me the codes are billable by an LPC with a Medical DX not a mental health DX.

But provider customer service can not provide the R&C for these codes.

Any help is appreciated.
Barbara
: Re: Pay Rate for H&B codes
: PMRNC August 14, 2014, 05:56:38 PM
Are you looking for fee schedule or U&C. You can't get U&C/R&C over the phone, carriers are not allowed to give them out. If you are non par you need to submit a pre-determination of benefits with the billed rate for each code. If you are par, you need to check your fee schedules.
Never a good idea to discuss rates on a public forum. Here's good article on these codes :)  http://blog.carepaths.com/2013/10/21/behavioral-health-cpt-codes-for-patients-with-a-physical-diagnosis/
: Re: Pay Rate for H&B codes
: barb2512 September 15, 2014, 02:44:21 PM
Thank you so much for your time. b.