Wiki OTP/MAT Billing

[thranowski]

Hello. I am relatively new to MAT and OTP billing. For Medicare patients, we use standard OTP G codes set. Does anyone know how E/M codes are covered? Are you allowed to submit 992XX along with G codes? We are not OBOT, we are OTP. We bill E/M codes for our Medicaid patients and some commercial patients depending on the fee schedule. Thank you.

 

[dvarn567]

If you bill the OTP G codes for your Medicare clients they are a bundled code and everything they have during that 7 day period is included. (ie, UDS, counseling, case management, etc) If they have a physician visit during that week you can bill a G2077 (periodic assessment, assessing periodically by qualified personnel to determine the most appropriate combination of services and treatment. ) that takes the place of an E/M code along with the primary code. Example: 07/09-07/15 G2067 (methadone) & G2077 (dr visit).