Wiki Billing H0015 for Daily 3-Hour Group Therapy in IOP - Medicaid and Medicare patients

[Diana.a.gaitan@gmail.com]

Hello everyone, I am seeking guidance on billing CPT code H0015 (Alcohol and/or drug services; group counseling by a physician or other qualified health care professional) for a specific scenario within our Behavioral Health Intensive Outpatient Program (IOP), particularly concerning Medicaid and Medicare billing.
Here's the situation:

• Clients attend three therapy groups on three designated days of the week.
• Each group session lasts 1 hour, for a total of 3 hours of group therapy per day with different providers.
  My questions are:

1. How are other organizations billing H0015 for a daily 3-hour group therapy session within an IOP setting, specifically when billing Medicaid and Medicare?
2. Are there specific modifiers that should be used to accurately reflect the 3-hour session?
3. Are there any specific Medicaid state guidelines that directly address billing multiple H0015 codes in a single day for IOP services?
4. Are there any specific payer guidelines, including Medicaid, regarding billing multiple H0015 codes in a single day?

I'm looking for best practices on how to accurately bill for these 3-hour daily group visits to ensure appropriate reimbursement and maintain compliance with Medicaid regulations.

Any insights, suggestions, or examples of successful billing strategies, especially those related to Medicaid, would be greatly appreciated.