Insurance Billing

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Mastering IOP Billing: CPT Codes, Insurance Reimbursement, and Licensing

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What is IOP Billing and How Does It Work? IOP (Intensive Outpatient Program) billing involves using HCPCS codes like H0015 (substance use IOP) and S9480 (mental health IOP) to submit claims for bundled daily services. Most insurers require pre-authorization, condition code 92 (for Medicare), and a minimum of 9 hours of weekly treatment to qualify for reimbursement. Proper coding, medical necessity documentation, and adherence to payer guidelines help ensure claim approval and avoid denials.

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2024 Update! Mastering CPT Codes for Residential Addiction Treatment Services: H0017, H0018, H0019

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The Centers for Medicare and Medicaid Services, also known as CMS, released their annual update to CPT/HCPCS codes on September 8th, 2023. 

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Medicaid Billing for Massachusetts Addiction Treatment Programs 

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You can find the entire range of CPT codes accepted for addiction treatment billing at MassHealth in Subchapter 6 of the MassHealth Substance Use Disorder Treatment Manual, under the header, “Substance Use Disorder Treatment Service Codes.”

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Medicaid Billing Secrets for Addiction Treatment in Tennessee

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Medicaid in Tennessee is called TennCare. According to a recent study, well over 65% of all addiction treatment centers in Tennessee accept Medicaid. That number is growing about .1% every year, with a total of 297 facilities treating SUD in Tennessee.   

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Medicaid Billing for Addiction Treatment in Arizona

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Medicaid in Arizona is called the Arizona Health Care Cost Containment System, or AHCCCS, for short. The vast majority of services delivered through AHCCCS are delivered by managed care health plans, rather than fee-for-service providers.

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Secrets of Medicaid Billing for Addiction Treatment in Washington

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The Medicaid program in Washington State is nicknamed Apple Health. Washington Medicaid will reimburse for a wide variety of addiction treatment services.

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Medicaid Billing for Addiction Treatment in Georgia

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Learn what treatment service categories are covered under Georgia Medicaid, as well as some of the most common CPT codes you’ll encounter when billing Medicaid for addiction treatment services in Georgia. 

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Six Frequently Asked Questions About Billing Medicaid for Addiction Treatment in Florida

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While Florida will cover inpatient, residential, and outpatient treatment for Medicaid patients with SUD, there are a number of services that are not covered under Medicaid rules.

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Secrets of Billing Medicaid in Pennsylvania for Addiction Treatment Services

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Finding information about billing Medicaid for addiction treatment services in Pennsylvania can be difficult. This post contains some tips and tricks - as well as some handy resources - to point you in the direction of the answers you need. 

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How to Bill Medicaid for Addiction Treatment in California 

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In this post, we’ll cover some of the main considerations you’ll want to keep in mind as you submit Medi-Cal claims in the Golden State. 

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Everything You Need to Know About Insurance Billing for Addiction Treatment in Pennsylvania 

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If you’re running an addiction treatment center, IOP program or any type of behavioral health concern in Pennsylvania, you know that addiction treatment billing in Pennsylvania is anything but straightforward.

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Understanding HCPCS and CPT Billing Codes for Addiction Treatment Detox : Inpatient, Residential, and Outpatient 

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Let’s dive into the most common addiction treatment detox HCPCS and CPT codes, what they mean, and when to use them.

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Understanding Medicaid Billing and Coverage for Addiction Treatment in Minnesota

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Medicaid in Minnesota - also known as “Medical Assistance” - is a popular option for many people seeking treatment for Substance Use Disorder in the North Star State.

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What Addiction Treatment Services Does Medicaid Cover in Colorado? 

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Colorado’s Health First program has a very robust coverage map for for Medicaid patients seeking addiction treatment and behavioral health services in the state.

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Understanding HCPCS and CPT Billing Codes for Outpatient Addiction Treatment: H0015, H2036, S0201, and S9480

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The two most important codes to understand for IOP are H0015, alcohol and drug services IOP program, and S9480, Intensive outpatient psychiatric services, per diem.

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Contingency Management May be Coming to an Addiction Treatment Center Near You

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How does contingency management work? Why is it so controversial? What does the future of contingency management look like in the behavioral health field?