Question Modifier 32

aviprasad

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Hi i am hoping i can get some help in understanding this Mod ( 32 ) we are billing for children under the age of 3 and the state mandates we provide the services to these children in their natural environment ( this is a state mandate ) would the use of this MOD be acceptable and usable for billing and reimbursement ? or is there another modifier that would suit these services better ?
 

vmoldovan

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Hi i am hoping i can get some help in understanding this Mod ( 32 ) we are billing for children under the age of 3 and the state mandates we provide the services to these children in their natural environment ( this is a state mandate ) would the use of this MOD be acceptable and usable for billing and reimbursement ? or is there another modifier that would suit these services better ?
What CPT(s)?
 

aviprasad

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We are an Early intervention and Neurodevelopmental center that provides Speech, Occupational, Physical and Mental health services. We bill evaluations and treatment for these disciplines (92523 and 92507-speech) (97165 and 97530 97112 97116 OT) (97162 and 97530, 97116, 97112 PT etc) (Mental Health 90791 and 98046 98047 ) We bill with Place of Service ("home-12"). That is where we get hung up on payments and authorizations. Many insurance carriers want to process benefits under home health and we are NOT home health and don't coordinate with home health. Our theory was that since Washington state mandates us to serve our clients in the "natural environment" we thought this might help.
 
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