Hearing that the CMS is establishing collaborative care billing codes got my hopes up that my therapists who specialize in children could begin billing for time they spend collaborating with teachers, PCA's, other providers etc.. But looking more closely at the specifics it appears these codes are only for primary providers. Does anyone know how to bill for time spent collaborating on behalf of a patient? Or is that time always considered part of the in-session billing code (i.e 90837)?

Anyone else having all of your H2019 U1 and H2019 U1 HQ (DBT codes) denying from Aetna or BCBS PMAP for DOS in 2017? Aetna is denying CO 45 because the system is not recognizing the modifiers of U1 and U1 HQ. Similiar issue with BCBS PMAP, their new claims system is not reading the modifiers, so they are denying CO 96 bc they think it's a hospital visit. This impacts our clinic in a huge way. If you're having the same issues, please contact your BCBS rep and let them know so they will understand how big of an impact this is. We don't really have an Aetna rep, so I have no one to communicate this with, except calling to get the claims reprocessed, which I should not have to do!

Great news! Our electronic client payments integration is now up and running. We just recently did a live demo last Thursday. But if you weren't able to attend, you can view a recording of it below or view an article on it in our Knowledge Hub here.

We are very excited to be partnering with Complete Merchant Solutions for this integration into Procentive. If you know that you are interested and want to find out more information, simply click here.

As of this year there is a new requirement for outpatient counseling for UCare for Seniors clients. A prior auth is required for anything other than an intake. This caught us by surprise and the provider newsletter it was featured in was very obscure.

Has anyone else experienced consistent denials with Aetna for med mgt codes: ie 99213, 99214, & 99215 for various reasons including no authorization, no referral or provider type cannot bill this procedure? Every time we call to see exactly why it denied, we get different answers. I've spend 1 hour today, trying to get to the bottom of it and I still don't know if I'm clear with what we need. Some reps say the plan needs a PCP referral, another rep says we need pre-auth, pre-cert dept says it's not needed for mental health, some say add modifier 25, etc... help!

How would you bill a 2 hour session with one provider and then bill another hour of resourcing with a different provider?

Has anyone in this community taken a coding class or have coders/billers who are well educated in the area of code stacking/billing multiple codes for one DOS with same provider? We have providers who render in home services that last longer than 1 hour and are trying to teach them how to code stack and then trying to figure out the best way to bill them to get them paid. Any help is appreciated!

Has anyone started billing for CTSS tx plans, and if so, are MA and PMAPS paying for them?

Does anyone know what the MA rate is for group skills?

At this time I'm just wondering if anyone is having these denials. We may be asking for help!

Our scenario: Starting in August, after BCBS MN had an update to provider types, we got denials for clients who see our LMFTs and have a BCBS IL plan through their employer. We have started an appeal process over these denials. Now BCBS IL has recouped payments made from Jan to July; we've included a request for re-payment in our appeal.

Thanks, Kay