It seems like medical billing codes are constantly being tweaked, changed, or redirected in how they can be used. For a small practice or solo practitioner it can feel very much like a hassle to keep up with them and all the changes in minutia codes like the place of service codes.
The truth is, providers everywhere frequently struggle to memorize billing codes that always seem to change. Yet it remains true that the proper use of all these changing codes plays a critical role in claim acceptance and maintaining a consistent revenue stream.
Even the slightest error, or missing piece of information, in something as seemingly insignificant as a place of service code, needs to be correctly listed and listed in the right field for it to be approved by an insurance provider or a public health institution. This is especially challenging when it comes to knowing which specific place of service code needs to be used for each patient’s case.
What Are Place Of Service Codes In Behavioral Health?
A “Place Of Service” code is essentially a two-digit number that healthcare providers place on billing claims to note the treatment setting or location where a service was rendered to a patient. They are especially important in both medical and behavioral health settings.
Since behavioral health providers can practice in a variety of settings, it can be a little more complicated to know when to use a particular place of service code. Not only can they vary by location, but the patient’s plan might only allow for certain codes. While it might sound like a minor factor, the place of service code you use can be a major factor when submitting a claim to a patient’s insurance company.
Most of the time, you as the provider will input the place of service code into section 24b of a CMS or an HCFA 1500 claim form. If you accidentally code the claim with the incorrect number, it will most likely be denied or you will experience a significant delay when the insurance provider reaches out to you for clarification or a correction.
Common Place Of Service Codes
It’s worth bearing in mind that there is a staggering array of locations where a place of service code can be used by a behavioral health therapist. Some are distinctly separated from other place of service codes that are used in other sectors of the healthcare industry. Some of the most common ones are:
- Code 02 – Telehealth Provided Other Than in a Patient’s home
- Code 03 – School
- Code 10 – Telehealth Provided in Patient’s Home
- Code 11 – Office
- Code 14 – Group Home
- Code 51 – Inpatient Psychiatric Facility
- Code 52 – Psychiatric Facility-Partial Hospitalization
- Code 53 – Community Mental Health Center
- Code 54 – Intermediate Care Facility/Individuals with Intellectual Disabilities
- Code 55 – Residential Substance Abuse Treatment Facility
- Code 56 – Psychiatric Residential Treatment Center
- Code 57- Non=residential Substance Abuse Treatment Facility
- Code 58- Non-residential Opioid Treatment Facility
How to Make Sure You are Always Completing This Process Accurately:
The fact of the matter is that each provider needs to be properly trained and well-equipped to handle the hassle of medical billing codes, and the place of service codes are no exception. When armed with the correct information, the right tools, and a proper understanding, or when you use a specific place of service codes, you can streamline your medical billing process.
Errors in coding tend to be the primary cause of claim denials. They are particularly important to your revenue and reimbursements. The fastest way to improve the accuracy of your billing codes is to use a comprehensive billing solution such as contracting with a third-party medical billing agency like Operant Billing Solutions.
While your in-house coding software can help streamline your claims process and reduce some common errors such as ensuring that all critical fields are filled in, even the best administrative or coding software is never perfect. Using a third-party medical billing agency can take the extra step of removing the burden you experience with your billing process, allowing you to focus more intently on your clients.
The Benefits Of Claim Outsourcing
Partnering with a third-party ABA billing agency like Operant Billing Solutions, which specializes in behavioral health billing comes with a lot of benefits. This includes ensuring that the correct place of service codes are used in the appropriate fields every time.
Peace Of Mind From Partnering With Experts
This starts with you not having to worry about the accuracy and efficiency of their claim process. By outsourcing your claims, your gain peace of mind that they are being handled by highly trained and experienced medical coding experts. This includes a trained eye dedicated to making sure that the place of service codes are used correctly in the proper fields.
Streamlined Reimbursements & A Consistent Revenue Stream
When you partner with a third-party medical billing specialist you will enjoy a significant reduction in billing code errors thanks to an overall increase in your clean claims. Of course, this also translates into a higher volume of timely reimbursements that further translates into greater consistency in your practice’s revenue stream.
Working with a managed billing partner can greatly increase your clean claims with claim validation and submission. Should a claim denial occur due to an incorrect place of service code, the third-party agency will be on top of and follow up in a timely fashion, to collect the corrected information as quickly as possible to minimize any further delays.
The Familiarity Of A Dedicated Billing Account Specialist
When you partner with a third-party medical billing specialist like Operant Billing Solutions, you will be given a dedicated behavioral health billing specialist that will work directly with you or your practice’s administrative staff. This includes access to regularly scheduled meetings and updates to ensure that you are always in the loop.
Increased Time & Focus
One of the great things that a lot of behavioral health specialists find when they partner with a third-party medical billing agency, is that they have more time to focus on treating patients. This can also include attracting and serving new patients, more time for continuing education, or expanding the business aspects of their small practice.