Treatment FAQ

what value code should i be using for intensive outpatient treatment

by Ms. Dahlia Koss Published 3 years ago Updated 2 years ago

Effective with dates of service on and after July 1, 2015, the only allowed place of service codes acceptable for billing SUD intensive outpatient services (H0015 or H0015 HA) will be 55 (Residential Substance Abuse Treatment Facility) and 57 (Non-residential Substance Abuse Treatment Facility).

IOP Billing: HCPCS and Revenue Codes
In most cases, you'll use the four-digit revenue code 0906 for intensive outpatient services, chemical dependency.

Full Answer

What is the CPT code for intensive outpatient psychiatric services?

Jul 13, 2016 · The HCPCS 2016 code is H0015, which is described as “Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education.” Note that one unit of service equals …

What is the IOP code for substance abuse treatment?

PHS or other federal agency (Payer Code F). Enter 6 zeros (0000.00) in the amt field if claiming conditional pay because there has been a significant delay in payment. A six zero value entry for Value Codes 12- 16 indicates conditional Medicare payment requested (0000.00) (Payer Code C).

What are the Medicare billing guidelines for inpatient outpatient programs (IOP)?

Jul 10, 2015 · Effective with dates of service on and after July 1, 2015, the only allowed place of service codes acceptable for billing SUD intensive outpatient services (H0015 or H0015 HA) will be 55 (Residential Substance Abuse Treatment Facility) and 57 (Non-residential Substance Abuse Treatment Facility).

What are the different revenue codes for IV therapy?

codes that specify assessment, e.g. 97755 – assistive technology assessment (which is not separately payable from the outpatient therapy per-session HCPCS code). • Assessments shall only be provided by clinicians, because assessment requires professional skill to gather data by observation and patient inquiry and may include

What is Revenue Code 0905?

HCPCS and revenue codes for IOPs

S9480/0905: The per diem outpatient IOP code for psychiatric issues which may include eating disorders, is S9480, and most times is always paired with revenue code 0905. This is generally used for private payers, as Medicare does not recognize these codes.

What is Revenue Code 0914?

The acceptable revenue codes are as follows: 0914. Individual Therapy.

What is Revenue Code 0912?

UB04 Revenue Codes 0912 in section: 091X - Behavioral Health Treatment/Services-Extension of 090X. HCPCS.

What is the difference between revenue code 0912 and 0913?

Florida Blue defines revenue code 0912 as partial hospitalization for chemical dependency and revenue code 0913 as partial hospitalization for psychiatric services.

What is revenue Code 510 used for?

Outpatient services, including ASC services, rendered in an all inclusive method rate provider will be billed using the 85X type of bill. Revenue code 510 should be on the bill with visits indicated in the units field and the dollar amount in the charges field.

What is revenue Code 636 used for?

We know that for Medicare claims, Revenue Code 636 is used for: 1) Inpatient – exclusively billing hemophilia clotting factors. 2) Outpatient – billing for "Drugs that require detail coding" (i.e., pharmacy with HCPCS).

What is Revenue Code 0240?

0240 in section: 024X - All Inclusive Ancillary.

What is Revenue Code 0915?

UB04 Revenue Codes 0915 in section: 091X - Behavioral Health Treatment/Services-Extension of 090X. HCPCS.

What is code G0410?

HCPCS Code for Group psychotherapy other than of a multiple-family group, in a partial hospitalization setting, approximately 45 to 50 minutes G0410.

What is Rev code for PHP?

Revenue code 912 for:

Substance Use Disorder Partial Hospitalization – all-inclusive per diem payment of three to five hours (half day)

What is CPT code S9480?

2022 HCPCS Code S9480 : Intensive outpatient psychiatric services, per diem.

What is CPT code H2036?

HCPCS code H2036 for Alcohol and/or other drug treatment program, per diem as maintained by CMS falls under Other Mental Health and Community Support Services .

What does code mean in Medicare?

Code indicates the amount of Medicare additional payment for new technology.

When to use the most recent hemoglobin reading?

Patients most recent hemoglobin reading taken before the start of the billing period effective 1/1/06. For patients just starting, use the most recent value prior to the onset of treatment. Whole numbers (i.e. two digits) are to be right justified to the left of the dollar/cents delimiter. Decimals (i.e. one digit) are to be reported to the right.

How many zeros are in a LGHP?

Portion of a higher priority LGHP payment made on behalf of a Medicare beneficiary that the provider is applying to Medicare charges on the bill. It enters six zeros (0000.00) in the amount field if it's billing conditionally for substantially delayed payment.

What happens if all deductible pints furnished have been replaced?

Number of unreplaced deductible pints of blood supplied. If all deductible pints furnished have been replaced, no entry is made.

When reporting numeric values that do not represent dollars and cents, what do you do?

When reporting numeric values that do not represent dollars and cents, put whole numbers to the left of the dollar/cents delimiter and tenths to the right of the delimiter.

What is FI approved?

FI approved the provider charging the beneficiary the amount shown for non-covered accommodations, diagnostic procedures, or treatments.

What is revenue code in medical billing?

The revenue codes in medical billing provide information to the insurance company on whether the services were performed like an emergency room service, operating room service, etc.

What is a revenue code?

Revenue codes in medical billing are 4 digit numeric ids that are used in hospital bills to notify insurance companies that what type of services received by patients. These are 4 digit number always starting with “0 (Zero)”. We have updated the list of Revenue Codes for Medical Billing as per the latest information effective on 15 March 2020.

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