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Place of Service Denials w/ Commercial Ins.

Scott VanBerkom 1 year ago in Billing/Electronic Modules updated by sarah 1 year ago 3

Anyone have an idea if Health Partners or (Any other commercial plans) Deny payment based on place of service (Anything other than Office or Telehealth) This one in question pertains to "School" as the place of service, the therapist is the treating provider. 

We are having problems with the Telehealth code Q3014 with HealthPartners.  I've used 11 and 02 for the place of service and they still deny.  If you are meeting with them in an office in the school, I would still use 11 instead of 3.

If you are billing in the schools, can you use the POS as 53 (community mental health center)? We have a lot of school based programs and we use POS 53

Some commercial payers will not cover school as a location, as they interpret that as a school employee seeing the client. They will not tell you how to bill, but they will agree if your clinician is using a room in the school as their office, it would be considered an extension of your business and may be billed as 11 - office as the POS.