Billing & Credentialing Cranberry Twp. (Pittsburgh)
  • Facebook
  • Linkedin
  • Twitter
  • YouTube
  • RSS
Call: (412) 219-4789 | Fax: (866) 422-9277
  • Credentialing
  • Payer Contracting
  • Medical Billing
  • Specialties
    • Behavioral Health
    • Toxicology
    • Genetic Testing
    • Pharmacogenetic (PGx) Testing
    • COVID-19 Testing
    • Allergy Testing
    • Skilled Nursing Facilities
    • Urgent Care
    • Oncology
    • Pathology
    • OBGYN
    • Biologics and Specialty Drugs
    • Telestroke and Teleneurology
    • Remote Patient Monitoring
    • Remote Therapeutic Monitoring
    • Home Infusion Therapy
    • Speech Therapy
    • DME
    • Substance Abuse
    • Sleep Study Labs
    • Physical Therapy (PT)
    • Occupational Therapy
  • HL7 Integration
  • RPA
  • Blog
  • Contact
  • Home
  • Healthcare Provider Specialities
  • Substance Abuse

Substance Abuse

Substance Abuse Billing Experts

Substance abuse refers to the habitual misuse of drugs or alcohol, leading to harmful physical, mental, and social consequences. Substance abuse affects people of all ages, genders, races, and socioeconomic backgrounds. It is a serious public health issue and can lead to a range of negative outcomes, including addiction, health problems, relationship issues, legal problems, financial difficulties, and even death.

Substance Abuse Billing & Credentialing

For medical professionals and / or doctors that are running an office-based program for Buprenorphine treatment (Suboxone®, Subutex®3, Zubsolv®4, Bunavail™5, Probuphine®6), there are often many questions raised on how to properly do the medical billing when filing claims through the patient’s health insurance plan. There are multiple insurance companies that require specific credentialing and coding for substance abuse or opioid addiction treatment practices. Adhering to the correct ICD-10 and CPT codes of a patient’s claims is imperative, in order to get maximum reimbursement. Medwave has a dedicated team of professionals that handle your claims. This will put your mind at ease, making absolutely positive that your substance abuse practice’s future is in good hands.

Coding buprenorphine for primary care physicians

There has been much success with insurance companies now covering the cost of buprenorphine treatment in a primary care setting using regular evaluation and management codes. These codes would be based on the complexity of care or the time spent with the patient.

Visits Breakdown

Visits

Assessment Visit

99205 of a new patient with a comprehensive evaluation
99215 of an established patient with a comprehensive evaluation

Induction Visits

New PatientEstablished Patient
99201 10-19 minutes99211 5-9 minutes
99202 20-29 minutes99212 10-14 minutes
99203 30-44 minutes99213 15-24 minutes
99204 45-59 minutes99214 25-39 minutes
99205 60+ minutes99215 40+ minutes

Maintenance Visits

99211 5-9 minutes
99212 10-14 minutes
99213 15-24 minutes
99214 25-39 minutes
99215 40+ minutes

There are currently some private health insurance carriers that are forming standard coding for these types of treatments with set reimbursement rates up to $300.00 per visit.

Mental Health Care, Unspecified

H0033 Administration of Oral Medication with direct observation.

Note to Medicaid Providers

If you are a Medicaid provider, you are bound by your contract to accept medical insurance as payment in full. It is illegal to ask patients to self-pay for treatment.

substance abuse billingMedwave Billing & Credentialing 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 billing and coding regulations. Our team is experienced and well educated in the medical billing and coding guidelines of specialists treating substance abuse and has firsthand experience working with commercial and government companies to get your claims paid fast and efficiently.

Our sole objective is to move your 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.

Contact us today to speak with someone on how we can be an affordable asset to you and your substance abuse treatment practice’s future in the Greater Pittsburgh region and the rest of the United States.

Recent Posts

  • Medical Credentialing Staff at a Hospital

    25 Stats Medical Credentialers Must Know

  • Older Female Doctor in need of Credentialing

    Credentialing Problems? We Can Fix Them!

  • Medical Credentialing State-by-State

    Multi-State Licensing in Provider Credentialing

  • Telehealth Provider

    Solutions for Telehealth Credentialing Challenges

  • Telehealth Credentialing Specialist

    What is Telehealth Credentialing?

Practices Served

  • Behavioral Health
  • Genetic Testing
  • Pharmacogenetic (PGx) Testing
  • Toxicology
  • COVID-19 Testing
  • Allergy Testing
  • Skilled Nursing Facilities
  • Urgent Care
  • Oncology
  • Pathology
  • OBGYN
  • Biologics and Specialty Drugs
  • Telestroke and Teleneurology
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Speech Therapy
  • Substance Abuse
  • DME
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy

Practices Served

  • Behavioral Health
  • Genetic Testing
  • Pharmacogenetic (PGx) Testing
  • Toxicology
  • COVID-19 Testing
  • Allergy Testing
  • Skilled Nursing Facilities
  • Urgent Care
  • Oncology
  • Pathology
  • OBGYN
  • Biologics and Specialty Drugs
  • Telestroke and Teleneurology
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Speech Therapy
  • Substance Abuse
  • DME
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy

Recent Posts

  • Medical Credentialing Staff at a Hospital

    25 Stats Medical Credentialers Must Know

  • Older Female Doctor in need of Credentialing

    Credentialing Problems? We Can Fix Them!

  • Medical Credentialing State-by-State

    Multi-State Licensing in Provider Credentialing

  • Telehealth Provider

    Solutions for Telehealth Credentialing Challenges

Quick Links

  • About Medwave
  • Regions Served
  • Medical Billing
  • Medical Credentialing
  • Payer Contracting
  • Specialties
  • HL7 Integration
  • Robotic Process Automation (RPA)
  • Denial Management
  • Revenue Cycle Consulting
  • Telehealth
  • New Practice
  • A/R Recovery
  • CPT Code Category Index
  • FAQ
  • Pricing
  • Blog
  • Contact

Quick Connect

  • (412) 219-4789
  • Fax: (866) 422-9277
  • Contact Us
    • Tumblr
    • Linkedin
    • Facebook
    • Twitter
    • Pinterest
    • YouTube


Medwave | Alignable

© 2024, Medwave Medical Billing, LLC. | Cranberry Township, PA, 16066 | Phone: (412) 219-4789 | Fax: (866) 422-9277 | Sitemap | Privacy Policy