Cwebb85
New
I bill for Applied Behavior Analysis services (CPT 97151-97158). These services are excluded from Medicare coverage. The rendering providers (Behavior Analysts) are not even eligible to register with Medicare. I have a client who has Medicare as primary and Medicaid as secondary. I was instructed to bill claims to Medicare (paper with GY modifier). I did and Medicare issued correspondence stating the claim could not be processed because the NPI is invalid. It’s a valid NPI, just not registered with Medicare. How would I get Medicare to issue denials for “non-covered service” so I can bill the secondary? The GY modifier is specifically designed for non-covered services.