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Substance Abuse Codes - Medicaid VS others

  1. Question Substance Abuse Codes - Medicaid VS others
    Medical Coding Books
    I have been billing for new SUD Medicaid patients to NH Healthy Families and Well Sense. Occasionally, I get bills for BCBS and Harvard Pilgrim. Do these insurers use different codes than Medicaid?
    For example: Medicaid uses H0001 and BCBS uses 90834 and both describe "Alcohol and/or Drug Intake Assessment". I am a little confused on why the different codes for the same thing?
    Will BCBS not accept H0001?

  2. #2
    Roanoke, Virginia
    CMS plans have some specific codes just for their use. It appears H0001 is for Medicaid agencies only, so looks like BCBS is a no-go. In the AMA 2014 HCPCS Professional Edition book all codes H0001 thru H2037 are covered by Medicaid and not Medicare.

    I'm in the behavioral healthcare field now, previously in family care and it kind of worked the same way with code specific services. You did provide ME with some useful info on the 90834, however, as I am new to this field, so thank you


  3. #3
    I have been approached by a Recovery Center (substance abuse) to assist with their billing. They are in the process of getting certifications, so they are not quite ready to start with patient treatments. Where is the best place for me to research how to bill for this type of center? This is totally new to me. Any assistance would be appreciated !

  4. Default
    Hi denali, I currently run a billing dept. for a substance abuse facility. Are they planning to do inpatient or outpatient, and what kinds of providers are they planning to use?

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