AAPC - Back to school
Results 1 to 6 of 6

Thread: Medicare and Mental health

  1. #1
    Join Date
    Apr 2007
    Lewiston Maine

    Question Medicare and Mental health

    AAPC: Back to School

    I am new to coding and billing and work for a non-profit mental health agency here in Maine. We have been billing all claims for Psychiatric Medication Management to Medicaid (called MaineCare in Maine) until 2008 when Medicaid guidelines/regulations changed and we had to change our licensing with the state. We know have a license for Maine that allows to bill services for Psychiatric Medication Management (code H2010 for HCPCS) to Medicaid and to Medicare under 90862 and M0064. The question is do we have to bill Medicare for clients that have Medicare Part B or can we offer to give this service to free? We have been working with a local consulting firm and have been given conflicting information. Our NP is licensed as a PMH-NP and does not require supervision anymore from a psychiatrist or MD. We also have an LCSW on staff that does assessments for us for other services that are reimbursed by MaineCare but no Medicare. We will need to bill his assessments possibly to Medicare for clients that have Medicare and Medicaid if we become contracted with Medicare. Does anyone have a good contact for discussing Medicare contracting questions especially in regards to Mental Health and enrolling?

    Thank you in advance for your assistance.
    Gretchen Lagassee

  2. #2


    If the patient has Medicare primary you would have to bill that first before you would be able to bill Medicaid - which will likely not pay any additional. If a patient has Medicare you can bill and should bill for the medication management (90862) that the NP and MD's are providing. It is a covered benefit under Medicare - we bill them in our office without any problems.

  3. #3
    Join Date
    Apr 2007
    Lewiston Maine

    Default -

    Thanks for the information. I have another question.
    Do you know if we have to have an MD or Medical Director on Staff to bill Medicare? We do not employ an MD or Medical Director currently. Our NP is an PMH-NP and is independent (does not require clinical supervision). We are a non-profit mental health agency. We are not setup as a clinical or an FQHC.

  4. #4


    We bill all of ours with an MD super, but if they are fully liscensed and able to bill on their own and are performing within the scope of their liscence you should be able to bill them. Make sure they are enrolled with Medicare.

  5. #5


    I have a quick question: is H2010 and 90862 essentially interchangeable?

  6. #6
    Join Date
    Apr 2007
    Greater Orlando

    Default H2010/90862

    No, they are not. H2010 is included in 90862 but is specifically for use when providing services to one with alcohol and drug treatment issues. 90862 is for general purposes.
    Good luck. Hope that helps.
    Anita Johnson, CPC, CCS, CPMA, CCS-P
    Orlando, FL

Similar Threads

  1. Medicare Mental Health Billing Out of State Please Help
    By CMBA4 in forum Medicare Regulations
    Replies: 0
    Last Post: 05-31-2012, 06:37 PM
  2. Medicare & Mental Health visits
    By deedeefronius in forum Behavioral Health
    Replies: 0
    Last Post: 10-28-2009, 02:14 PM
  3. Mental Health Visits for Medicare pts.
    By deedeefronius in forum Medicare Regulations
    Replies: 0
    Last Post: 10-28-2009, 02:13 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.