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Group: Forum Members
Last Login: Wednesday, February 11, 2009 4:51 PM
Posts: 2,
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| I attended the 2008 Association of Asthma Educators conference and was challenged to bill for all asthma education regardless of if it will get paid or not. The hope is to show that asthma education is being done and should be paid for. I am an RRT and AE-C and cannot be reimbursed for asthma education in my state (SD) at this time. I think it is important to get all asthma educators on the same page, so we are billing with similar codes for similar prices and also communicating what is working for everyone else. My questions to you are: What codes are being used for asthma education? How much are you billing for/charging? Are your claims getting paid? What documentation do you use? Thanks and good luck to everyone increasing the standards of care for asthmatics!
Rae O'Leary, RRT, AE-C
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Group: Forum Members
Last Login: Monday, September 22, 2008 7:45 AM
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| Good Morning Rae, I'm sorry it has taken me so long to respond to your question. Have you researched the National Asthma Educator Certification Board's website? They have a page devoted to reimbursement. I've copied & pasted the site: http://www.naecb.org/cbr/state.htm. You can click on your state to find out specific information about reimbursement for asthma education. Gloria Ayres, Program Director American Lung Association of the Midland States
Gloria Ayres, Program Director
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Group: Forum Members
Last Login: Wednesday, February 11, 2009 4:51 PM
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| Here's some responses I got from the same discussion in an AARC Message Board: From a Director of RC: I am trying to set this fee up now at our facility. I have been told that the CPT code for one on one is 98960 which is a 30 minute session If you are teaching a class of 2-4 the code would be 98961, a class of 5-8 is 98962. All codes are for 30 minute sessions. We document under the patient education section in the charting. We do give at our book regarding asthma which includes; triggers, medication, exercising ect. We also have RRT with the AE-C to educate the classes. I go the codes from the NAECB.org who sited AARC as a reference. From and RT in FLORIDA:
I used to bill private insurance for coaching,teaching and training the patient when I delivered DME and got paid for it. I used 94799...
For Medicaid(under 21yo) it's billed for a visit of therapy face to face to a patient in 15 minutes units and
the code is G0238.
Medicare does not reimburse the visit of a RRT. We're working on it,though. Let's keep on trucking about this; someday we will be paid for what we truly do and know.
I have been doing asthma education for 31 years and it's about time I get paid for it. A few others reported charging between $36.26 and $50 for each 30 minutes of one-on-one asthma education (code 98960). The BREATHE Program has decided to charging $45 for 98960, with the expectation that it will not get paid due to Medicaid failing to recognize RT's and non-physician healthcare providers. What's important is that asthma educators show that they are educating and making a difference and should be reimbursed for their services.
Rae O'Leary, RRT, AE-C
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