Some payers like to make up their own rules stricter than AMA's CPT Guidelines. Maybe check with Medicaid to see if they can point to a policy?CodingKing,
Thanks for your reply.
We already do send the claims out on separate claim forms but our Medicaid MCO's have suddenly started denying. They are paying the 90791 and saying the E/M code is concurrent. In the 2016 CPT book it states: Codes 90791, 90792 may be reported once per day and not on the same day as an evaluation and management service performed by the same individual for the same patient.
I thought since the 2 services were provided by 2 different providers it would be payable.