Medical Billing Forum

Coding => Coding => Topic started by: ERBurley on August 23, 2017, 02:21:51 PM

Title: G9001 Billing
Post by: ERBurley on August 23, 2017, 02:21:51 PM
Please assist!  I help bill for a Psychologist, PHD who mainly offers therapy to children.  Recently he has gotten information from Amerigroup (medicaid managed care) that G9001 can be billed as part of coordination of care with the referring physician. 
This is accurate, however my experience with G codes is as an add on to a procedure code E/M with billing of $.01.  This is more of an information code for CMS/medicare part B. 

I have done much research on this and it looks like this particular code may be billed alone as with a fee, does anyone have any experience or advice. I will greatly appreciate any help.  Thanks!!!
Title: Re: G9001 Billing
Post by: Michele on August 24, 2017, 08:35:39 AM
The G codes that are add ons to E/M with a $.01 are PQRS codes.  And actually do not have to have the $.01 charge.  We submit ours with $0.00. 

There are also G codes that represent billable procedures and those would be submitted as such.  The G9001 is one of those such codes and would be billed with the provider's charge for coordiantion of care.
Title: Re: G9001 Billing
Post by: ERBurley on August 29, 2017, 09:09:15 AM
Thank you for your response.  That is what my research has revealed.

Now, are there guidelines as to fee schedules?  CMS is so vague...  Thank you!
Title: Re: G9001 Billing
Post by: kristin on August 29, 2017, 03:55:53 PM
I found a fee schedule for this code from a BCBS Med Advantage plan that had an allowed amount of $130.41 effective 1/1/2017...try Googling G9001 fee schedule and see what you find.
Title: Re: G9001 Billing
Post by: ERBurley on August 30, 2017, 10:55:17 PM
Thanks so much!