Billing for house calls

Alyson Zurek, LICSW 4 years ago in Billing/Electronic Modules updated by John-Debbie Trunk 4 years ago 2

This question was just posed to me by one of my IC's. I have a private practice, not behavioral health clinic. 

Can we make house calls (treatment in the clients home) to patients and still bill 90834/90837 to insurance companies? Is there also a travel code ( I think that is only used for MA/behavioral health clinics and CTSS), but wondering if available for private practice?

Commercial payers generally take the position of your payment for the visit including any of your travel cost. They don't usually accept travel codes billed. Before you bill a home visit, it would be a good idea to call the specific payer. Some require an auth in order to see a client at home, but some will allow a child to be seen in the home if it is medically necessary. We make a lot of preemptive calls.

I'm recalling many years ago some payers will allow a child to be seen in the home if medically necessary as Sarah posted. I would also recommend calling the health plan in advance and inquire. I have had travel codes not reimbursed. I'm drawing from my experience from years ago. It is not current information. Call the health plan in advance to obtain details of how they view this type of service. When in doubt, call first.