Wiki Lcsw

[hgarrett113]

I am trying to figure out how to bill for an LCSW out of a privately owned pediatric office. We would see mostly medicaid (NC). I know that with Medicaid you can use H codes but what is the difference in billing an "individual therapy" codes vs billing H0004??? And how do you find out what codes can be billed together. For example, if she sees the child for 30 minutes, then sees the family w/o child for 15 minutes. Can both of these codes be billed together and is a modifier needed??

Any help would be greatly appreciated. Thanks!!

Hollie Garrett, CPC CPEDC

 

[hgarrett113]

Please.... can anyone point me in the right direction or give me some sort of reference that I can look into. Thanks!

 

[smdumpert]

I suggest looking at your state's Medicaid website. It should be able to help. In our area our therapist are able to provide and bill for CPT codes, 90801, 90802, Individual therapy 90804, 90806, 90806, 90810, 90812, 90814. They are also able to bill for 90847 family therapy and 90853 group therapy. As well as a few others. CCI edits will prevent certain codes from being billed together. As far as H codes, our area is limited regarding which codes we can use. Our state's Medicaid has very specific instructions on which codes and when they are appropriate. In our area, it is suggested by our Medicaid payer to bill for the service that takes the most amount of time at that session. Hope this helps.