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Billing for a Suboxone Treatment

  1. Default Billing for a Suboxone Treatment
    Medical Coding Books
    How do I bill Medicare for a Suboxone treatment? One of our providers is interested in this and I am having difficulties finding an answer. Thanks, Angela CPC

  2. #2
    Default
    What type of treatment? You can email me and maybe I can help.
    Herbie W Lorona Jr., CPC, CPC-H
    hlorona@up2parmedicalclinic.com

  3. Default Suboxone Visits
    We have two providers that offer this service. We code an e/m plus the additional code for monitoring the patient. The provider has to indicate in the office note how much time was spent during the entire visit. We use 99354 for the first hour and 99355 for each additional 30 min. We haven't had a Medicare patient come in for this yet. They have all be Medicaide of Washington patients so far.

    Nichole

  4. Question
    I have a question on the refills of suboxone and how to bill for this service. Can you help me?

  5. #5
    Location
    Columbia, MO
    Posts
    12,531
    Default
    Quote Originally Posted by cnramsey View Post
    We have two providers that offer this service. We code an e/m plus the additional code for monitoring the patient. The provider has to indicate in the office note how much time was spent during the entire visit. We use 99354 for the first hour and 99355 for each additional 30 min. We haven't had a Medicare patient come in for this yet. They have all be Medicaide of Washington patients so far.

    Nichole
    The provider must be in the room with the patient the entire time you are billing for with the prolonged codes. I am not certain Medicare will reimburse for this but I do know the documentation needs to be perfect.

    Debra A. Mitchell, MSPH, CPC-H

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