Medical Cannabis (Marijuana) Billing & Credentialing
Medwave has a dedicated team of medical billing and credentialing experts to help you maximize your office’s reimbursement and keep you up-to-date with today’s ever changing medical marijuana billing and coding regulations. Our team is experienced and well educated in the medical billing and coding guidelines of medical marijuana primary care providers and specialists and has firsthand experience working to get your claims paid fast and efficiently. Our sole objective is to move your medical cannabis office to a more efficient and effective work process so that your claims reimbursement is at its maximum. Utilizing the most current ICD-10 and CPT coding ensures that your office’s claims are clean and paid the first time.
Medical marijuana is not typically covered by insurance because it is not recognized as a medicine by the federal government. The Federal Drug Administration (FDA) has not approved medical marijuana as a safe and effective treatment for any medical condition, and it remains classified as a Schedule I controlled substance under the Controlled Substances Act. Because of this, insurance companies are not required to cover it and most choose not to. This may vary by state, as some states have legalized medical marijuana and have laws that require insurance companies to cover it, but this is not yet a widespread trend.
*Currently, most major insurers and Medicaid / Medicare do not cover medical marijuana treatment, since cannabis is a controlled substance on the federal level. However, if you’re a medical marijuana provider and perform services that are covered by the aforementioned insurers (no matter what they are), then reach out to us. We’ve helped a number of groups get credentialed and bill for internal, alternative services.
Medical Cannabis Billing FAQ
What billing and credentialing services does Medwave offer medical cannabis providers
Medwave provides medical billing and credentialing support for medical marijuana primary care providers and specialists. The team applies current ICD-10 and CPT coding to keep claims clean and get them paid on the first submission. Their goal is to move a cannabis office toward a more efficient billing process so reimbursement is maximized.
Does insurance typically cover medical marijuana treatment
Medical marijuana is not typically covered by insurance because it is not recognized as medicine by the federal government. The FDA has not approved it as a safe and effective treatment, and it remains a Schedule I controlled substance under the Controlled Substances Act. Because of this classification, insurers are not required to cover it and most choose not to.
Do Medicare and Medicaid cover medical marijuana
No, most major insurers along with Medicaid and Medicare do not currently cover medical marijuana treatment. This is because cannabis remains a controlled substance at the federal level. Coverage decisions are largely shaped by this federal classification rather than by individual medical need.
Are there any exceptions to insurance coverage for medical marijuana by state
Coverage can vary by state, since some states have legalized medical marijuana and passed laws requiring insurance companies to cover it. This is not yet a widespread trend across the country, though. Providers should check their specific state rules to know what applies to their practice.
Can a medical marijuana provider still bill insurance for other services
Yes, if a medical marijuana provider performs services that are covered by Medicaid, Medicare, or other insurers, Medwave can help with billing for those services. Medwave has helped a number of groups get credentialed and bill for internal or alternative services beyond the cannabis treatment itself. Providers in this situation are encouraged to reach out directly for support.
Why is up to date coding important for medical marijuana billing
Medical marijuana billing and coding regulations change frequently, so using the most current ICD-10 and CPT codes helps keep claims clean. Clean claims are less likely to be rejected or delayed, which supports faster reimbursement. Medwave’s team stays current on these guidelines to help providers get claims paid efficiently.