Texas Medicaid and Texas Health Step medical check up screenings

mckaya

Contributor
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Location
North Richland Hills, TX
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Effective November 1, 2015, Texas Medicaid new benefit
Procedure code 99420 will be a benefit for clients who are 12 through 18 years of age
when services are provided by THSteps medical and federally qualified health center
providers once per lifetime.

Some providers are billing an office visit E/M code for the checkup and procedure code 99420 with modifier 25?
Is the modifier correct coding for the mental health screening, procedure code 99420 on the same date as the checkup when Medicaid is requesting services to billed on the same claim?
 

CodingKing

True Blue
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Modifier 25 would go on the full office visit code to show it's significant and separately identifiable from other procedures performed on the same date of service.
 
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