Author Topic: ABA Therapy/Speech Therapy  (Read 643 times)

Missjay

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ABA Therapy/Speech Therapy
« on: October 17, 2016, 02:18:55 PM »
BCBS TX are denying stating that BH Therapy and Speech Therapy cannot be billed on the same day even though it is two different providers. Have any of you ever seen this? 

Michele

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Re: ABA Therapy/Speech Therapy
« Reply #1 on: October 18, 2016, 08:17:26 AM »
I have not billed for BH therapy and speech therapy on the same day so I can't say that I've seen this.  Is it being billed by the same group NPI and EIN/Tax ID?  That may be the issue.  Their system may not allow two therapies by the same group in the same day.  I hate to sound like a broken record but I would call and speak to someone about this too.  Maybe it's a system edit but it can be overridden.  Or it may be that they just don't allow it.
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Missjay

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Re: ABA Therapy/Speech Therapy
« Reply #2 on: October 19, 2016, 09:24:46 AM »
Thank you for your response..
The NPI is different because it is two different therapists. One is a BCBA and one is a SLP. The denial came back stating it's mutually exclusive and not recommended for Individual Reimbursement.

Michele

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Re: ABA Therapy/Speech Therapy
« Reply #3 on: October 19, 2016, 08:34:40 PM »
I know that the rendering provider is different but what about the billing information in box 33?  Are the two therapists in the same location?  Or did the patient go to two separate therapists in two separate locations?  Have you called to ask for clarification?  If they are completely separate providers using different billing NPIs and Tax IDs/EINs then the policy may not allow speech and BH therapy on the same day.  Personally I have not seen that and it seems odd.  They are unrelated.  But if the therapists work in the same group at the same location that may be the problem even if they are different therapists.
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