Medical Billing Forum
Billing => Facility Billing => : rb2007 April 20, 2016, 03:27:04 PM
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Regarding Mental Health and Substance Abuse, is there a specific number of members that must be attending a group, in order to bill services under group codes? 90853 standard group?
H0015/0906 Intensive Outpatient Program?
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I don't see a specific number. According to the American Psychological Association group sessions are between five and 15 patients.
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When I initially read your question, I immediately answered to myself "more than 2, less than 15, per Medicare". But when I tried to find that in writing I was not able to. But I used that standard when I billed MH services for years.
What I did currently find is several insurance carriers define group size differently, some saying more than 2, less than 10, less than 12, less than 15, etc. It's a good question... and may be best answered by payer of the billed group service.
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Each insurer has different rules. But it's irrelevant for billing.
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Each insurer has different rules. But it's irrelevant for billing.
I was going to say same thing.. makes no difference really unless they all have the same insurance plan and that would be freaky !!