Coding > Coding

How can I bill a 90806 & 90853 same day to Medicare

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Lisa@srts-inc.com:
Hello,

I am trying to bill an individual therapy (90806) and a group therapy (90853) on the same day for the same patient to Medicare ( Massachusetts) but they are denying.  I tried to bill one visit with modifier 25 and still denied.

Any suggestions??

Thanks
Lisa

rdmoore2003:
Is the rendering provider the same for both services?

camedbill:
I don't believe you can bill two therapy codes on one day especially to Medicare regardless if same provider or not

rdmoore2003:
The only way that it could be done is if it is separate rendering providers under separate group numbers. 
But yes generally you cannot have two therapies in the same day.   you cant do 96101 and 96102 in the same day either.

Lisa@srts-inc.com:
Yes, it is the same rendering.  The provider told me that the hospital she works for is able to do this but I never considered that they are probably billing the same patient but 2 different providers.

Thanks so much for the help.
Lisa

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