Wiki 90791 & 99406-99407

[lizziemcd]

When billing Ohio Medicaid for smoking cessation (99406/99407) and a assessment (90791) is the 99406/99407 added on to the 90791 or billed on a separate claim (1500 form)?
Thanks

 

[sls314]

When billing Ohio Medicaid for smoking cessation (99406/99407) and a assessment (90791) is the 99406/99407 added on to the 90791 or billed on a separate claim (1500 form)?
Thanks

Here's a provider billing fact sheet from Ohio Medicaid - it looks like they want a 25 modifier on the 99406/99407 when billed with another exam.

https://odh.ohio.gov/wps/wcm/connect/gov/f4749c0e-2aa7-4623-b741-710c370098a2/Provider+Fact+Sheet-approved.pdf?MOD=AJPERES&CONVERT_TO=url&CACHEID=ROOTWORKSPACE.Z18_K9I401S01H7F40QBNJU3SO1F56-f4749c0e-2aa7-4623-b741-710c370098a2-nz6Qybd#:~:text=Ohio%20Medicaid%20covers%20all%20seven,over%2Dthe%2Dcounter%20medications.

 

[sls314]

I should add that I haven't billed Ohio Medicaid for smoking cessation recently, because I work in a specialty practice now.

However, the fact sheet should be a good reference for you.

 

[lizziemcd]

Thanks! I saw that too and read it a few times (more than a few lol)....so your understanding of this is one 1500 claim from with both codes and the 25 modifier for the 99406/99407?