Author Topic: Pay Rate for H&B codes  (Read 1523 times)

barb2512

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Pay Rate for H&B codes
« on: August 14, 2014, 11:23:01 AM »
Does anyone currently bill the following codes for a LPC?
96152
96154
96155

The counselor I work for is wondering what the reimbursement rate is for these codes. I have called Cigna, UBH and CareFirst. They tell me the codes are billable by an LPC with a Medical DX not a mental health DX.

But provider customer service can not provide the R&C for these codes.

Any help is appreciated.
Barbara

PMRNC

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Re: Pay Rate for H&B codes
« Reply #1 on: August 14, 2014, 02:56:38 PM »
Are you looking for fee schedule or U&C. You can't get U&C/R&C over the phone, carriers are not allowed to give them out. If you are non par you need to submit a pre-determination of benefits with the billed rate for each code. If you are par, you need to check your fee schedules.
Never a good idea to discuss rates on a public forum. Here's good article on these codes :)  http://blog.carepaths.com/2013/10/21/behavioral-health-cpt-codes-for-patients-with-a-physical-diagnosis/
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

barb2512

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Re: Pay Rate for H&B codes
« Reply #2 on: September 15, 2014, 11:44:21 AM »
Thank you so much for your time. b.