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Wiki H0020 Unbundling Rules for Different Providers

jabell82

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Berea, KY
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We recently received a few overpayment requests on codes 90785 & 90833 stating that they were "overpaid due to unbundling of services" and that per KY Medicaid CPT H0020 is a weekly bundled code and CPT codes 90785 & 90833 are included in this weekly rate. However, we are not the provider or group that billed the H0020 code. This code is for drug & alcohol services, which is not the reason we are even seeing these members. We are seeing them for mental health reasons not related to drugs & alcohol. Can anyone tell me if this accurate that no other provider can bill for codes included with H0020 if that code is being billed by another provider/group? Thanks.
 
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