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245G Comprehensive assessment & intake billing

Susan Connolly 9 months ago in Billing/Electronic Modules updated by Jeremy Roelofs-Lynch 3 weeks ago 4

We have been receiving some information/advice on how to properly bill for a comprehensive assessment and also bill for intakes in our  new chemical dependency program.

Our thought is to use code H0001 for the comprehensive assessment itself, but we have also been advised that there should be a billing for group time.

Can anyone provide some insight on why group would be billed as well?  If billing for time spent on the comprehensive assessment is allowed, shouldn't that be billed as individual?

Hey Susan,

That is very interesting advice. I would agree, there should be no group billed unless group was attended. Otherwise we bill it as a CAS H0001 as that was what the individual service was. 

Did they explain why they thought that ? 

For intakes, we bill the H0001 for the comp assessment, and also an H2035 for individual time.  Granted, our intakes last an hour and a half.

If a comp assessment is being completed, it should be billed as H0001 with 0944 or 0945 rev codes.  There are some payers that have designated a different rev code - I think PrimeWest and maybe BCBS MN?

For the intake session, it should be billed as H2035 with 0944 or 0945 rev codes and the appropriate number of units (31 minutes to 1 hr 30 minutes is 1 unit; 1 hr 31 minutes to 2 hrs is 2 units).

If you haven't done so already, and you're in MN, I highly recommend you spend time reading the state statutes and the MHCP provider manual section on SUD.

Hi!

I wanted to add to this and see if anyone had any feedback.


With direct access if a client has a Comp completed and it is denied or taken back due to more than 2 in a 6 month rolling time period can we bill it out at a Rule 25 Assessment like we have in the past before the Direct Access/Comp Assess changes....???

Thank you,

Jeremy Roelofs-Lynch