MTM billing

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I searched for similar threads but I couldn't find any.

The only carrier I know who seems to be reimbursing for MTM services is HUMANA through Outcomes (getoutcomes.com).

Does anybody know of any other carriers who are reimbursing??? Thanks!

 

[Farmercyst]

That's funny because the "similar threads" box at the bottom of the thread has about 4 on this very subject.

 

[Meditech]

I searched for similar threads but I couldn't find any.

The only carrier I know who seems to be reimbursing for MTM services is HUMANA through Outcomes (getoutcomes.com).

Does anybody know of any other carriers who are reimbursing??? Thanks!

you should be able to bill medicaid /medicare part D using the code 99606 for intial encounter, i mean MTM performed face to face with a patient in a time increment of up to 15 minutes and for subsequent encounters for same patient for time increment of 15 minutes.
Use code 99607 as an add on code for additional increment of 15 minutes for use with the above code.

Hope this helps

 

[spacecowgirl]

That's funny because the "similar threads" box at the bottom of the thread has about 4 on this very subject.

We're still working on our billing process. It's really going to depend on the payers in your state, but many use the HCFA-1500 form for billing if you are in an amb care setting. Not sure how you would do that in retail unless your computer system lets you generate 1500 forms😕 In my state Medica, Humana, BCBS, MA and several state-specific payers have MTM benefits.

I think the first place to look should be your state MA program. A lot of them pay for MTM.

I have spent over a year working on this issue. It's obviously very complex and you have to talk to a bunch of people at each insurance company before you get anyone who knows what in the heck you're talking about. Not a very good process just yet.