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Methadone Insurance Billing

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terral_p:
Good Day,

We are trying to determine the CPT codes for Drug and Alcohol claiming for Insurance.  We are using the Medical H0020, with the HG modifier, however, we are unsure of what the CPT code for the Insurance company should be.  Due to Gross MediCal billing we want to make sure we have accurately claimed the services to Insurance prior to claim to MediCal.

Would appreciate any guidance.  Thanks

Michele:
Can't really help with the information that you are giving.  There are many different ways of treating Drug & Alcohol services and each has coding.  There isn't one 'universal' code.  It would depend on the services that are being provided.

terral_p:
My apologies the three types services would be:

METHADONE MAINTENANCE/SITE       
METHADONE MAINTENANCE/COURTESY 
TAKE HOME METHADONE MAINTENANCE

For California they are all Mode 15, SFC 20

Does this help?

Thanks

Michele:
Not really, they sound like internal descriptions.  Are you billing on CMS forms or UB04's?  What are the actual services?  Counseling?

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