Billing

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Comprehensive Guide to Mental Health & SUD Treatment Credentialing

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Credentialing is the backbone of professional practice in mental health and substance use disorder (SUD) treatment. It refers to the rigorous process of verifying and validating a provider’s qualifications, licensure, training, and experience before they are allowed to deliver care or receive reimbursement.

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Comprehensive Eating Disorder Treatment Planning for Behavioral Health Professionals

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Eating disorders are among the most challenging conditions in mental health – not only because of their complex clinical presentation and high mortality rate, but also due to the myriad compliance and reimbursement hurdles that providers face.

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Insurance Reimbursement Rates for Addiction Treatment

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Struggling with low insurance reimbursement rates for addiction treatment and mental health services? Our comprehensive guide breaks down the essential CPT & HCPCS billing codes, payer reimbursement strategies, and expert tips to reduce denials and increase revenue. Learn how to navigate Medicaid, Medicare, and private insurance billing effectively and ensure your facility gets paid what it deserves.

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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 - Most Commonly Used Addiction Treatment and Behavioral Health CPT Codes for Billing and Reimbursement

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When the CMS drops a new update to existing codes, it’s considered a “new codeset” - a shiny new box of codes that addiction treatment billers can use to communicate about services rendered with insurance payers. 

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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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Master Medicaid Billing for Addiction Treatment in Michigan

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The most common name of Michigan Medicaid is simply Medicaid. However, there are some circumstances where you’ll hear Medicaid plan names such as Healthy Michigan Plan, Children’s Special Health Care Services, MIChild, or Maternity Outpatient Medical Services

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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.