MAPS-MD Issues Bulletin

MARCH, 2000

 

Interdisciplinary Meetings (W9510)

Just a reminder: As required by the Code of Maryland Regulations, reimbursement for treatment planning (W9510) may be claimed only once every six months.

 

Enhanced Client Supervision:

This service must be billed in whole units. This service can be billed electronically. If you have been partially paid on a previous claim, do not send it again electronically because it will deny as a duplicate. Please send such partially paid claims, listing the correct number of units, and a cover letter indicating that these are partially paid enhanced client supervision claims needing for the original claim to be retracted and the attached claim to be processed in its place, to:

Claims Manager
P.O. Box 624
Owings Mills, MD 21157

 

New Rates:

New rates have been published on the MAPS-MD Web site. The majority of the new rates were effective March 1, 2000. Please also find on the Web site the service matrix and the billing modifiers matrix.

 

Billing Training Sessions:

Just a reminder: There are few training sessions left. This training is for billing personnel or for anyone who wants to know more about the basics in billing MAPS-MD. The following are the remaining sessions:

April 14, 2000 MD Dept of Agriculture(Annapolis) (9-12 a.m. – HCFA 1500 / 1-4 p.m. UB92)
April 25, 2000 Allegany Community College (9-12 a.m. – HCFA 1500 / 1-4 p.m. UB92)

 

Attention UB92 Billers:

Beginning May 15, 2000 claims billed in the following manner will be denied. These rules are based on requirements by Medicaid that have been in place since 1995.

    1. Outpatient UB92 claims billed with more than 1 day on a claim will be denied.
    2. Outpatient UB92 claims billed with a late charge (135 bill type) will be denied. If a charge needs to be added since the original bill, a corrected bill with all charges for that day must be sent in to MAPS-MD (bill type 137).

Also, please see the attached crosswalk of revenue codes versus CPT codes. HCPCs are not required for UB92 billers; however, it is important that when billing to be sure that the appropriate services are being billed with the corresponding revenue code.

 

Respite Care

Respite care can only be authorized to providers who have been reviewed and approved by the Office of Health Care Quality (OHCQ). The applicable CPT codes are:

W9528 In Home Respite Services. The rate is $8 -$12 (rate negotiated with CSA) up to a maximum of 10 hours a day.
W9553 Children in facility based program. This type of respite is provided in a group home or therapeutic foster care program.
W9552 Adult Care, per day. Respite services for an adult consumer, per day.

(W9528 can not be authorized along with W9553 or W9552)
Only those providers that have been approved by OHCQ can perform these services.

 

Maryland Medicaid & Maryland Health Partners Revenue / CPT cross-reference