Author Topic: Nursing Home Billing  (Read 1108 times)

Migualla

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Nursing Home Billing
« on: July 09, 2010, 11:47:22 AM »
Hello,  I have a question.  I do the billing for a group of Psychologists in MO.  We are branching out to see clients in a nursing home setting.  One of our Psychologist will receive a referral and then go to the nursing home to do an assessment and then further weekly sessions if needed.  I have never billed a nursing home visit before.  I assume there is a cpt code.  We are currently billing through WPS.  Any tips or suggestions to help a biller out?? Please!!
« Last Edit: July 09, 2010, 12:03:28 PM by Migualla »

PMRNC

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Re: Nursing Home Billing
« Reply #1 on: July 09, 2010, 12:11:13 PM »
Since it's a psychologist you would still use same CPT codes but diff place of service. Be careful of covered diagnosis, there's a lot of Medicare with Nursing home naturally and even psychiatrists have hard time with reimbursement for many diagnosis's wtih medicare patients.  Usually I tell my non MD mental health clients it's not worth it.. JMO
Linda Walker
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Michele

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Re: Nursing Home Billing
« Reply #2 on: July 12, 2010, 09:59:08 AM »
We bill for a couple of psychologists who do the nursing home thing and do very well at it.  Remember that visits are not covered by Medicare during the first 100 days of the stay.
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Migualla

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Re: Nursing Home Billing
« Reply #3 on: July 28, 2010, 04:00:10 PM »
Is there a link that someone could post to cms billing for Nursing homes.  I would like to know the rules before we start the game!  Even if I needed to purchase a manual I would.  I have spent the last couple weeks looking for the provider manual on CMS but was unable to find it.  I also went to our carrier, which is WPS and came up empty there.  Thanks for any ideas.

PMRNC

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Re: Nursing Home Billing
« Reply #4 on: July 28, 2010, 06:19:23 PM »
You just need to follow mental health billing procedures. The thing with Medicare is they will also base coverage on medical necessity as well as prognosis. Nursing home professional charges are just prone to more scrutiny with mental health providers, so it's real important that the face sheets you get contain the referring physician.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com