Author Topic: 96101  (Read 1521 times)

TammyL

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96101
« on: October 22, 2012, 03:42:54 PM »
I Billed Tricare for a 90801 and 96101 the patient was inpatient at the time of service when the testing was done but they included these services in the mental per diem payment which means it was included in the patients stay so how do I get this claim paid since the services were done by a Phd is there a modifer I need to use or place of service I billed 51 Pos and 90801, 96101 x3, 96101 total claim $875.00 and the doctor got zero for providing these services.

PMRNC

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Re: 96101
« Reply #1 on: October 22, 2012, 03:45:11 PM »
If they included it with the per Diem wouldn't the provider go to the hosp for reimbursement? I'm not sure why they would combine professional services with facility payment of inpatient stay?
Linda Walker
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rdmoore2003

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Re: 96101
« Reply #2 on: October 22, 2012, 03:47:06 PM »
If they included it with the per Diem wouldn't the provider go to the hosp for reimbursement? I'm not sure why they would combine professional services with facility payment of inpatient stay?

also, is the PhD networked with tricare?  is he individual or hospital employee?
Regina