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Wiki OTP/MAT Billing

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thranowski

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Maitland, FL
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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.
 
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).
 

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