0

CTSS Place of Service

mboron 3 years ago in Billing/Electronic Modules updated by Tina B 3 years ago 6

What Place of Service are providers billing for CTSS? We are co-located in the schools with our own offices seeing clients.


We are billing POS 3-school and are getting some denials from TEAM (BCBS), Cigna and some UBH plans. Are there other POS codes we should use for this?


Thanks!

We have IDT programs also and we bill using the place of service as (53) Community Mental Health Center

When billing CTSS, place of service should only be Patients Home, School, or Other (99).

If CTSS is provided in an office setting (it should not be) but pick Other and specify why.

If other location is picked, then for BCBS and UBH plans specifically they often want you to send in the supporting documentation. So our Practitioners are advised that if they pick the (99) Other location, they need to write the location into the note.


i.e. This provider met with client at the library . . . .

Are you billing for the SLMH Program?

Yes, we are.

If you get a PR 96 or PR 204 denial from primary you can forward balances to SLG if client is authorized for SLG as a secondary payer to pick up deduct/copay/coins.

I have a related question. Would this be the same for 90837 if seeing a child in school? We get denials from BCBS saying not the correct code, but we've asked them what the correct code is and they won't tell us. Example: if we see a child at school for counseling (not at our agency or at their home), do we use 90837 and POS as 99 with explanation or is there a different CPT code as well as POS code we should be using? TIA!

We use location of School and there is no problem getting paid