Medical Billing Forum

Billing => Facility Billing => Topic started by: krudolph on May 27, 2009, 09:34:22 AM

Title: Mental Health Billing
Post by: krudolph on May 27, 2009, 09:34:22 AM
Does anyone know the correct codes and/or modifiers to bill Medicare Part B for IOP Treatment performed in a Facility setting?  Also, can this be performed by a LISW?  I know Medicare Part B services are to be billed on a CMS 1500.  If you bill a 90853 the reimbursement is only $27.66 and they are seeing the clients 3x week for 3 hours a day so I know this is not the correct code for this service.  Anyone with any knowledge on this your response would be very helpful.  Thank you.
Title: Re: Mental Health Billing
Post by: Michele on May 27, 2009, 09:47:11 AM
If the provider is set up as a facility you can bill the treatment out as facility fees, but the billing is done on a UB04 and you have to use rev codes.  I think the rev codes you are looking for are 0944 - drug rehab or 0945 - alcohol rehab.  They do pay higher for those.

Michele
Title: Re: Mental Health Billing
Post by: Cindy on May 27, 2009, 09:48:02 AM
try S9480 for procedure code.  Look it up first..
Title: Re: Mental Health Billing
Post by: Michele on May 27, 2009, 09:49:53 AM
Sorry, I just reread your question and realized my answer wasn't correct.  You cannot bill Medicare part b for anything other than the professional charges which would be cpt codes.  The previous answer only applies to other insurances.

You would have to be credentialed with Medicare as a facility and bill part A.

Michele