Author Topic: Out patient mental health at a facility  (Read 2042 times)


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Out patient mental health at a facility
« on: June 17, 2013, 08:20:21 PM »
I am billing for a Mental health/substance abuse facility.  We provide RTC, PHP and IOP.  We just started doing outpatient.  I am not sure what codes to use and not sure what form to use a UB or HCFA form?


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Re: Out patient mental health at a facility
« Reply #1 on: June 18, 2013, 08:25:51 AM »
I would strongly urge you to get some training. The providers SHOULD be doing the coding, not you unless you are a certified professional coder. Professional charges go on the CMS1500 (not called HCFA in years) facility charges are put on the UB-04.  2013 brought all new codes to mental health with the use of E/M, if you are not familiar with coding you might want to get some training and again, make it clear your providers or a CPC should be giving you the charges to bill already CODED!
« Last Edit: June 19, 2013, 09:27:44 AM by PMRNC »
Linda Walker
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Re: Out patient mental health at a facility
« Reply #2 on: July 31, 2013, 03:55:28 PM »
If the daily rate is $400 per day/ can you break out the therapy sessions that are being provided in the RTC (it is licensed as RTC)? The sessions are not a separate charge; they are included in the daily rate which covers R&B and therapy; but the family is asking us to prepare something for just the therapy sessions that are being provided by the LCSW. They said that most RTC facilities will do this as they had two other daughters go to 2 different RTC and they provided me with a claim form that the facility prepared for them. The other facilities are not listing anything but the therapy sessions and using a value code of 01 with the daily rate $400.00.
We are OON and I know this is not our problem but I was just curious if this was fraudulent to do? I am little confused on the unbundling of charges as I have been told several different things by several different people/insurance companies. I tend to tread on the side of caution......
« Last Edit: August 07, 2013, 10:25:52 AM by Angie »