Residential Treatment Center - Adolescent BH Charge Structure

elisa.paul@montagehealth.orgelisa.paul@montagehealth.org
in CHARGEMASTER & CHARGE CAPTURE

I am looking for a facility with experience with residential treatment charge structure. We are opening an adolescent BH residential treatment facility later this year.

We are an acute care hospital and the RTC will be off site. Any help with revenue codes, HCPCS, and general information would be appreciated.

Elisa, Community Hospital of the Monterey Peninsula

elisa.paul@montagehealth.org

Comments

  • Andrew.ReitenAndrew.Reiten

    We used to have a hospital-based RTC but closed it several years ago. Another claim element I remember would be UB-04 Type of Bill codes. Per NUBC, this would be 086X, but it is likely that not all payors will accept it.

    I believe this area still extremely payor-specific, so you will need to look at each payor contract, check each payor's Manual/policies, and/or contact each payor for Revenue Codes, HCPCS, and Type of Bill.

    A tip: if you have a larger payor that has a specified way to bill, it may be helpful to negotiate contracts with smaller payors using the same Revenue Codes, HCPCS, and Type of Bill. With some payors you will have to negotiate a contract or addendum anyway in order to add RTC, so this might be an ideal time to communicate with the payor on the billing elements.

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