Wiki LSW - Can you bill?

[amattingly2020]

We are FQHC and have several LSWs. I'm confused on how to bill LSW! First, I didn't think we could. Second, I have higher ups saying to bill under the LCSW as the rendering and billing provider and to use a HE modifier. Can someone shed some light on this? I appreciate any feedback. Thanks!

 

[rhotonscott]

LCSW bill under their own NPI. For Medicare, they are paid at %75 of the Physician fee schedule amount. Normally the FQHC facility NPI is used for billing NPI and and the LCSW would be the rendering NPI

 

[TThivierge]

Hi Amattingly,
LCSW and LPC can bill CPT 90832-90837, groups CPT 90853 not more than 10 in a group setting & note for each patient in group too. CPT 90846-90847 family sessions, Adaptive Beh assessment codes may help too CPT 97151. If do pt . Phone calls..they must call pt. you can use CPT 98960-98966 phone calls only for LPC and LCSW . Psychiatrist can use CPT 99441-99443 but with phone calls must get pt. permission, verify on top of record got correct person, and put how long call/time and what was discussed and list of dx on med record. If do use CPT 90832-90837 by telehealth video or Zoom use modifier 95 on these codes. Sometimes video not work can transfer to phone call but must tell this fact in documentation. ensure describe pt problem of dx blocks of F10-F19, F06, F32, F33, F43, Etc. with proper Z dx codes if applicable and block dx R45 differ mental health symptoms if apply. If pt has past mental health problem years ago put date this happened, distinguish remission vs current history and types of sub abuse. Yes the payer usually Medica may want the modifier HE define the type for education and therapist license. Verify all this with each payer to lessen denials plus ensure each LCSW and LPC credentialed. Good Luck!
Well I hope I helped you
Lady T