Medication-assisted treatment, buprenorphine (oral) Use to cover episodes of care lasting 7-days in a rowĭon’t bill for same patient more than once for 7-day period These rules apply when billing OTP G-codes: If you provide a drug with or without additional non-drug component services, bill the appropriate G-code describing the weekly bundle including the drug. If you don’t provide a drug to the patient during that episode, bill the G-code describing a weekly bundle without including the drug (HCPCS code G2074), and then bill at least 1 service in the non-drug component. Organizational NPI as the billing providerīe sure to provide at least 1 service (from either the drug or non-drug component) to the patient during the week that corresponds to the episode of care.NPI of the person prescribing or ordering medication.Codes describing add-on services, including the date the service.HCPCS codes associated with the OTP service.Place of Service (POS) code 58 (Non-Residential Opioid Treatment Facility).TOB 013x for hospital based and TOB 085x for Critical Access Hospitals-based OTP services.Condition code (89) for provider-based OTP.Type of Bill (TOB) code (087x) for freestanding non-residential OTP.Clinicians can’t use OTP codes to bill for office-based treatment. If you’re a clinician, visit Office-Based OUD Treatment Billing for more information. Check your patient’s Medicare eligibility. There’s NO copayment for OTP services for Medicare patients but the Part B deductible does apply. Certified peer specialists or others permitted to give this type of therapy or counseling by state law and scope of practice.Licensed clinical alcohol and drug counselors.
Licensed marriage and family therapists.Licensed professional counselors/mental health counselors.Professionals who can provide substance use counseling and individual and group therapy included in the bundled payment may include: Medicare pays enrolled OTPs bundled payments based on weekly episodes of care. MHRA 'OTP', All Acronyms, 6 June 2023, Bluebook All Acronyms, OTP (Jun. OTP, All Acronyms, viewed June 6, 2023, MLA All Acronyms. Retrieved June 6, 2023, from Chicago All Acronyms. Facebook Twitter Linkedin Quote Copy APA All Acronyms.
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