How do you/can you bill for 2 hours of therapy by the same provider?

Tina B 7 years ago in Billing/Electronic Modules updated by anonymous 7 years ago 12

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

This sounds like something that could be accomplished with two separate service lines, each associated with their respective time/date of services and associated billing codes.

If the same code on same day

For example H2014 AU be sure that they go together on the same claim. (same PR #)

Do you know if you need to be contracted for this code with the insurance companies?

Do bill any code you would need it to be on your contract with that specific payer.

I wasn't saying to use the H2014 code or the UA modifier.

UA modifier is for CTSS clients.

I was giving an example of what I have seen used and paid successfully when two providers provide a service in the same day for the same client.

Using modifiers 76 and 77: Repeated procedure(s)

To use these modifiers, the repeated procedure must be exactly the same as the first and be performed on the same day.

Modifier 76: repeat procedure by same physician- This modifier indicates that a procedure or service was repeated in a separate session on the same day by the same physician.

Modifier 77: repeat procedure by another physician- Modifier 77 indicates that a procedure had to be repeated by a different physician/counselor in a separate session on the same day.

I remember that DHS removed the use of -76 and -77 modifiers last year for most services but you'd have to look that up. SInce then we have only used 59/XE/XP for mental health therapies.

Has any one been successful in billing 2 CD codes on the same day (one individual and one group for H2035)?

We are also running into some issues with claims being denied when more than one drug test is being billed on the same day for a given patient. Example code 80300 to 80371 (Drug test codes) and code 82075 (Breathalyzer). Any good fixes for those?

Yes, have had success with one individual and one group cd code on same day. Again the "trick" is that they need to go together on the same claim.

No experience with Drug testing sorry.

Do it all the time. Just make sure they both go out on the same invoice....particularly if BCBS is the payer to avoid late charges.

As for the use of modifiers, I have never needed to use a modifier when billing group and an individual sessions on the same day. I would think the use of...

Modifier 76: Denotes a repeat procedure by the same physician. Should be submitted only when a procedure is repeated on the same date of service by the same physician

...would not be appropriate given each service is separate and different type of service.

Modifier 77: Denotes a repeat procedure by another physician. Should be submitted only when a procedure is repeated on the same date of service by another physician

...And the same would be true with this code since both each service is a different using a different code.

As for billing, we have successfully billed for point of care testing (qualitative) by using H0048 for collecting the specimen and G0434 for the actual test (again this is for qualitative POC testing) and sending these claims out a professional on a HCFA 1500.