initial eval MH and med management

Valerie1 5 years ago in Industry News/Discussion updated by Susan Davis LICSW 4 years ago 2


I have BCBS claims that are denying for the med management initial eval due to the client has been seen for MH already at our clinic.  While it makes some sense that it is a different type of eval, the claims still deny.  Our taxonomy code is single specialty.  My question is, even if we send the claims with a different taxonomy code for that one provider, will it still deny since our clinic taxonomy is single specialty?  The provider wants us to change our taxonomy to multi specialty but we are unwilling to do that much work.  Has anyone had success getting paid for 2 types of evals?

BCBS just started denying 99205 for us as well. They even took money back

I would suggest you change your taxonomy code to reflect that you are a multi speciality.  Secondly, if this provider or anyone else in this clinic has billed 99205 in the past 3 years, then it will be denied.  99205 and 99204 can only be billed every 3 years.