It’s a common misconception that federally qualified health centers in Texas can’t bill for two services in one day because federal Medicaid rules won’t allow it. Participants in the Hogg Foundation’s Financing Integrated Health Care webinar learned that this belief and several others that stand in the way of funding integrated health care are simply myths.
The reality is that allowing multiple billing in a single day is a state-by-state Medicaid decision, not a federal rule or regulation. For example, Georgia does not allow two services in one day to be billed, but Texas does – provided that one service is a medical professional service and the other is a non-medical professional service. In fact, in 28 states including Texas, providers currently can bill and be reimbursed for more than one same-day service in the Medicaid program.
In addition to shedding light on common misconceptions, the webinar shared specific billing strategies for financing integrated health care. One example is to create partnerships between federally qualified health centers and community behavioral health centers in the delivery of integrated health care, particularly in providing and billing for case management services. Case management for special populations can be billed by both federally qualified health centers and community mental health centers.
Evaluation and management codes correspond to a physical health condition. In Texas, providers can associate a behavioral health service code, such as depression, with a physical health diagnosis code, such as a backache.
During the webinar, examples of how to effectively use the 9600 Codes – Health and Behavioral Assessment/Intervention were discussed, as well as screening, brief intervention and referral for treatment codes for substance use providers.
Refer to the Interim Financing Solutions for Integrated Healthcare in Texas worksheet for details and guidance.
To learn more about how to finance integrated health care in your community or clinic, listen to the webinar archive.