Author Topic: OH IOP & PHP BILLING  (Read 2504 times)

Cindy

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OH IOP & PHP BILLING
« on: May 27, 2009, 10:23:21 AM »
PLEASE, PLEASE HELP

Is there a standard definition of IOP and PHP?  Also on UB04 how do I bill,  a flat rate per day or by the # of hours client attended.  We are an outpatient day treatment facility.  So far not one of the insurance companies including Medicare will answer my question. 

krudolph

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Re: OH IOP & PHP BILLING
« Reply #1 on: May 27, 2009, 10:54:38 AM »
I bill IOP for a Drug and Alcohol Facility.  First you need to be set up as Facility Billing on a UB04 with insurance carriers.  If you are a contracted provider for a Facility you should have negotiated a "Per Diem" fee with the carriers.  We bill $275.00 per IOP Session and get reimbursed as low as $130.00 and as high as $175.00 per session from our contracted providers.  Your claims should be set up to be billed with the Facility Information including the Facility NPI and you would bill a "H0015" with the flat fee you charge.  We use a "HO" modifier and revnue code 0906.  Hope this helps.