Medical Billing Forum
Billing => Billing => : cwitt49 January 15, 2012, 07:48:52 PM
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I bill for a small Speech Pathology group and our usual CPT code 92507 has a fee of $100.00 for 1 hr therapy. I have been asked to bill for a half hour only ($50.00- same code 92507) for one patient since the patient is only able to come in a half hour at a time. I know that this is a non-timed CPT code, however I have not been able to explain this to the owner of the company in a way that he understands. I believe the Insurance Company Blue Cross would look at this unfavorably. Please let me know if this is correct or if there is a way to bill for only 1/2 hour. Maybe you have some suggestions as to how we can approach this problem. We are not contracted with any insurance company, we bill as a service to the patients that have Insurance that will cover this type of Therapy. Thank you for your help -
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I'm not a coder, however can't you use the modifier -52 and bill the $50?
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-52 means a reduced service. That should be the correct way to bill it. The insurance company won't care. They'll pay the allowed amount for the code. If you're billing less than the allowed amount for the code, you'll probably get your full amount billed.
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Thank you so much!! Yes I believe the -52 works!! I had looked through the modifiers at one time, but must have passed right over -52 since I have never used it!! I appreciate your help!!