Medical Billing Forum

Billing => Billing => : billinggirl January 06, 2012, 04:05:51 PM

: Out Patient Substance Abuse facility
: billinggirl January 06, 2012, 04:05:51 PM

One of my new clients, has an Out PT reatment facility.  Where they offer a program to the pt's.   They are billing for COunseling on the UB04 for OUt pt. 
Second if they need to take a patient as an IN Patient they house them as someone elses facility.  So it is my understanding that they cannot bill for facility charges for OUT Pt.  They can only bill for professional services on the 1500 form.   Is that correct.  The provider of services is a LHMC with a CAP.   

Please tell me if I am correct.   

: Re: Out Patient Substance Abuse facility
: Michele January 09, 2012, 01:50:04 PM

I would think it would depend on how they are enrolled with the insurance carrier, as a facility or as a professional provider.  We have had individual providers that meet the guidelines for a facility so their services were billed as a facility on the UB04 (all outpatient).

: Re: Out Patient Substance Abuse facility
: billinggirl January 09, 2012, 01:59:54 PM

Guess i'll have to check with them.   
thanks