Billing > Billing

3 visits same day

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Lisa@srts-inc.com:
I actually bill for another group and we can bill for a therapy visit (90806) and a med visit (90862) on the same day and the carriers do pay, so I was hoping just adding an OT visit for these new providers that all 3 would pay.

Lisa

PMRNC:
Hmm.. what carrier is reimbursing that? I know Medicare doesn't. 90862 is actually a med check with minimal therapy. Only my psychiatrist gets reimbursed for his quick med checks using the HCPCS code M0064  It doesn't matter if they are seeing another provider.  For example, just the other day we tried to get authorization for a patient coming in for 1 hour therapy session after she had not been seen in a month. When we called to get the authorization they told us another authorization already existed for another provider. We contacted the patient and let them know she could do both visits but her carrier was only going to pay for one and that she would need to pay in full.  turns out she was actually "torn between two therapists" LOL

Lisa@srts-inc.com:
I am in Massachusetts and we do get paid for a 90806 and a 90862, same day, different clinicians by BC/BS, United Beh(& Pacificare), and Tufts.........and United Beh/Pacificare will only charge a co-pay for one of the services, not both.

They were just credentialed by Medicare so I haven't seen if they will pay both yet but I am assuming they won't from what you have told me here.

Thanks for the info, this site is so helpful!
Lisa

PMRNC:
I do a lot of BCBS but they farm it out to TPA's and they won't cover two visits. YOU can have the psychiatrist bill out the M0064 for a quick med check on same day as a therapy visit. Medicare is actually watching psychiatrists and their overuse of the 90862 for quick med checks.

camedbill:
I thought M0064 is only used to bill Medicaid? Can this be used instead of 90862? Is reimbursement more or less?

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