Billing > Facility Billing
Out patient facility billing for substance abuse and Mental health
billinggirl:
I have a client that offers only Out patient substance abuse and mental health services. They are billing for Out pt treatment using the CPT codes starting with 9. I've always used rev codes like 0912 or 0906 etc. If an ins asked us to bill with HCPCS would use the H0035
or H00015. Does anyone know which is correct. I have only seen the H codes along with Rev Codes. If its the H codes how can I go about asking the facility to use them on the superbill without offending anyone?
Thank you
Michele:
Do you mean they report the services to you using cpt codes that begin with 9 and you are only familiar with billing rev codes and/or hcpcs codes? Sorry just not sure of the question. If they are billing using cpt codes such as 90801-90853 then they are billing on CMS forms instead of UB04's. Just not sure I understand completely to answer.
billinggirl:
they are billing using the 9 codes for professional services on the ub04, which is incorrect. my question is, if they are providing out patient treatment can we bill for daily rates just as if they were a residential facility. Can i bill for separate charges for using the facility just like we do for residential services. See the difference with this facility is that the patients do not live there but they come in as out patient treatment. I am used to billing for residential treatment where they live there for 3 to 6 months. I am used to billing professional charges on the cms 1500 and the ub04 is for facility charges. Out patient is new to me. hope it makes sense
PMRNC:
No, they can't.. if that were the case therapists could charge for the use of their office. The professional components of the therapy visits for the outpatient care are inclusive. Billing daily rates would only be appropriate for inpatient.
Angie:
If it is Residential Treatment (inpatient) we can put the professional fees on the UB04 even if it is all inclusive and show the room and board am I correct?
Using the 0914-0916 Individual, Group and Family and the Residentail Procedure codes 90818 Individual ect.....?
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