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Alcohol and Drug Abuse Residential Treatment Facility

meg006

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I work for a new facility that provides individual and group counseling for substance abuse and co-occurring disorders. There are medical and behavioral health staff whom provide treatment. It is a 24-hour facility (not a hospital) and the length of stay varies from 30-90 days.

I am looking to connect with others who are familiar with billing for these types of facilities. What is the appropriate code to use for billing the facility daily charge? The code range I am looking at is H0010 – H0019. I also see revenue codes 1002 (Residential Treatment Chemical Dependency) and 906 (Behavioral Health Treatments/Services Chemical Dependency).

Any assistance would be greatly appreciated.
 
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EMHaven

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I work for a new facility that provides individual and group counseling for substance abuse and co-occurring disorders. There are medical and behavioral health staff whom provide treatment. It is a 24-hour facility (not a hospital) and the length of stay varies from 30-90 days.

I am looking to connect with others who are familiar with billing for these types of facilities. What is the appropriate code to use for billing the facility daily charge? The code range I am looking at is H0010 – H0019. I also see revenue codes 1002 (Residential Treatment Chemical Dependency) and 906 (Behavioral Health Treatments/Services Chemical Dependency).

Any assistance would be greatly appreciated.
I am the insurance and billing coordinator for a Sub Abuse facility. I'm also looking to network with others in this field. It's not always easy to navigate! My email is emily@thehaven.com if you want to reach out. What state are you in?
 

sjsand65

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Location
hendersonville/asheville, NC
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I have been billing and collecting for sub acute substance abuse in and out patient services for a little over 4 years. If there is anything I can do to help, let me know. I an in North Carolina now, but have been in Malibu, CA previousely for 4 years or so. I would love to be able to network as well.
 

EMHaven

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I have been billing and collecting for sub acute substance abuse in and out patient services for a little over 4 years. If there is anything I can do to help, let me know. I an in North Carolina now, but have been in Malibu, CA previousely for 4 years or so. I would love to be able to network as well.
Any experience with Blue Shield of CA. Their rates seem so low and I can't even get our sub acute paid at all!
 

crichmond

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Hey!

I am also in the field. I've been working in substance abuse since 2010, and have experience billing in different specialties over the last 4 years. I am currently working in a 24 hour facility (SA/MH, TJC Accredited) in Utah.

Look forward to networking with you!
Courtney
Richmond.m.courtney@gmail.com
 

wdrega

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Networking

Add me to the list please. I've been in the behavioral health industry for 10 years. I am currently working at a co-occurring residential substance abuse facility. We provide LOC 3.5 to 1 as well as full psychiatric services. We regularly add new services such as relationship/sex addiction therapy, gambling, acupuncture etc. I always have questions when they throw the new stuff at me. windydrega@gmail.com.
 
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Behavioral and Substance Abuse Billing

I just started in this field/specialty, but have been in billing for almost 20 years. This is a whole new world for me lol. I am looking to learn more about the behavioral health redesign Medicaid is doing - I am in OHIO but not sure if this redesign is nationwide? I work for Brightview, a fairly new treatment center with a few locations. Specializing in addiction, they do custom programs for each patient addressing their specific needs. It is outpatient only, but patients are here several times a week sometimes depending on where they are at in their program, for drug tests, both screens and full panels, and then individual counseling, group counseling, and office visits. As this is a fairly new business AND a fairly new "specialty", the management is still kind of learning as they go, and the credentialing is a nightmare. I am interested in any info that may be useful in these areas, thanks!
 

LMBENHOFF

Contributor
Messages
18
Location
Rockford, Illinois
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Residential SA and Mental Health Provider Agency Coder

Please add me to your group for Networking. 20 years in Coding 2 1/2 in Behavior Health. Anyone out there charge for Suboxone Induction Services? Would love to here what codes and reimbursement you are getting for it! Regards, Lisa
 

gheredia07

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I am also new to drug abuse and behavioral treatment. Previous specialty was orthopedic professional and now working with sub-acute outpatient/inpatient behavioral health and chemical dependency and would love to connect with you all. They have code set developed, but I am concerned with the potential of unbundling services. Could someone please let me know if biopsychosocial evaluations are included when patients are at any level? Also how are you billing for Urinary Analysis and Breathalyzers?

my email: gheredia23@gmail.com.

Thank you,
Geena
 
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Oh boy another newbie!

Hi all,

I am new to substance abuse billing as well, any feedback on what residential services encompass (H0018) without room and board? What is room and board when it is in a residential setting? What is residential? Is it just a daily rate for the patient being there? And room and board is for....???? Sorry, have only dealt with room and board in Hospice. Any help with H0015 vs H0018 would be appreciated. They are telling me that they bill H0015 with room and board via a higher rate and modifier??

Vicky
 

NStone

Contributor
Local Chapter Officer
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20
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I'm late to the thread but if anyone is willing to give out their contact info, I would appreciate it. I work in physician billing and one of our clients is building a drug treatment facility in Western NY and would like us to do the billing for facility and the providers. I and my colleagues are at a loss. I can be reached by email at NStone@sticomputer.com.

Thank you for any and all help!
 
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Billing Coordinator

Hi there, I am currently doing billing for four residential treatment facilities and am very interested in networking with other in the field. Please email me kburdette@usaddiction.com
We have been using a third-party billing service and are now bringing the billing in-house. My position has gone from nursing to Billing Coordinator. I would love to network with others in the field to make sure I am billing correctly.
 

beth1010

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SA Residencial Facility, CA TX Claims Resolution Spealist

I would also like to network with others in the industry. Primarily out-of-network (except BCBS TX) therefore navigating payers preferences, while understanding the effects of REV and HCPS is super challenging.

If anyone has payer reference material or links to good sources please send via email. I will do the same. Personal email BHoffman1010@gmail.com.

Look forward to this fourm.
 
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Detox residential and pho billing

We bill for sub acute detox, residential, and pho. I would love to network as well. I am curious if anyone else has any tricks to get anthems rates up. We bill 4500 for detox in CA and they pay 900. All the other insurance companies seem to be reasonable. I am appealing and now onto second level appeals. It seems their allowable based on UCR is extremely low and unreasonable for the services we provide. The members policies say they will pay 70-80 percent but we are getting paid closer to 10-20. I have requested evidence of coverage and they refuse to provide it and state the payment is paid correctly using rates in network providers would accept however we are out of network. If anyone has any suggestions please email me. I’m not giving up on this one. justsarahk@gmail.com
 

lapalmes

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Location
Campbellsville, KY
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KY Billing Supervisor

Hi all!

I've only been in this field for a little over a year, but have worked at a SA/Co-occurring MH RTC/IOP/OP for the last 8 years. I'd love to network with you all, particularly about maximizing our billing. We're starting to bill for our medical services and I just feel like we may be using some less than ideal codes for our MH services, but I'm not sure. I'd also like bounce some questions around about Medical Detox since we're looking to add that service to our RTCs.

sydney.ayers@isaiah-house.org

Thanks!
 

Jlm101512

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Billing supportive housing

Hello,
Do you know what rev code to use for Supportive Housing? H0043, H0044?
 

EMHaven

Contributor
Messages
23
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We bill for sub acute detox, residential, and pho. I would love to network as well. I am curious if anyone else has any tricks to get anthems rates up. We bill 4500 for detox in CA and they pay 900. All the other insurance companies seem to be reasonable. I am appealing and now onto second level appeals. It seems their allowable based on UCR is extremely low and unreasonable for the services we provide. The members policies say they will pay 70-80 percent but we are getting paid closer to 10-20. I have requested evidence of coverage and they refuse to provide it and state the payment is paid correctly using rates in network providers would accept however we are out of network. If anyone has any suggestions please email me. I’m not giving up on this one. justsarahk@gmail.com
We are contracted with Anthem here in CA and get decent rates, Blue Shield is our biggest headache...I’ll try to email you.
 
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