#1 Substance Abuse Disorder Billing Services in Ann Arbor, Michigan
Treatment for SUD typically includes a combination of behavioral therapies, counseling, medication-assisted treatment (MAT), and long-term support. Despite the availability of effective treatments, a large portion of individuals with SUD do not receive the care they need. There are many barriers, such as stigma, lack of access to services, cost, and insufficient insurance coverage, that continue to prevent many from seeking help.
To support recovery and improve access to care in Ann Arbor, Michigan, investing in Substance Abuse Disorder Billing Services in Ann Arbor, Michigan becomes essential to assist both providers and patients. These services help providers in maintaining a healthy cash flow while reducing the administrative burden on internal staff. Better billing leads to better access to care, better outcomes, and a stronger healthcare system for everyone affected by substance abuse.
SUD billing refers to the process of coding, submitting, and managing insurance claims for addiction treatment services. It involves using standardized coding systems such as ICD-10-CM for diagnoses and CPT/HCPCS codes for procedures and services delivered. In addition to these, providers must also comply with federal regulations such as HIPAA and 42 CFR Part 2, which are designed to protect the privacy of individuals undergoing addiction treatment.
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Billing and Coding Guidelines for Substance Use Disorder
Stronger Billing. Faster Payments. Better Care for every SUD Patient in Ann Arbor, Michigan
Coding Systems and Diagnosis Representation
In SUD billing, ICD-10-CM codes represent the specific substance involved and the nature of the disorder, such as abuse, dependence, withdrawal, or psychotic episodes. These range from:
- F10: Alcohol-related disorders
- F11: Opioid-related disorders
- F12: Cannabis-related disorders
- F13: Sedative, hypnotic, or anxiolytic-related disorders
- F14: Cocaine-related disorders
- F15: Other stimulant-related disorders
- F16: Hallucinogen-related disorders
- F17: Nicotine dependence
- F18: Inhalant-related disorders
- F19: Multiple/unspecified substance-related disorders
Each code is further specified by use patterns (e.g., with withdrawal, with intoxication, or in remission). Proper coding helps providers in Ann Arbor, Michigan reduce claim errors and improve accuracy.
CPT Code Selection
CPT codes are widely used by providers in Ann Arbor, Michigan for documenting the exact clinical services provided during an encounter. These codes include:
- 90791, 90792: Psychiatric diagnostic evaluations
- 90832, 90834, 90837: Individual psychotherapy (30–60 mins)
- 90846, 90847: Family therapy
- 90853: Group therapy
- 90863: Medication management in combinaton with therapy
- 99408, 99409: Alcohol or substance use screening and brief interventions
- G0396, G0397: Brief behavioral counseling for alcohol/substance use
Bundled Codes for Office-Based SUD Treatment
CMS offers bundled G-codes for comprehensive outpatient treatment, especially for opioid and alcohol use disorders:
- G2086: 70+ minutes in the first calendar month
- G2087: 60+ minutes in subsequent months
- G2088: Add-on code for each additional 30 minutes beyond the above services
These are used for structured care plans and multiple service types delivered together in Ann Arbor, Michigan outpatient clinics.
Preventive Screening and Brief Intervention
CMS supports early identification and brief counseling interventions for at-risk individuals for alcohol or substance misuse:
- G0442: Annual screening (15 minutes)
- G0443: Brief face-to-face behavioral counseling (15 minutes)
- G0396: Short counselling sessions (15–30 minutes)
- G0397: Extended counseling sessions (more than 30 minutes)
These services are often performed in primary care settings in Ann Arbor, Michigan, and require proper documentation of risk factors and time spent.
Safety Planning and Follow-Up Services
To reduce overdose risk or psychiatric crises, Medicare allows billing for:
- G0560: Safety planning for patients at risk of suicide or substance use crisis
- G0544: Follow-up contact intervention after overdose or crisis-related event
These services must be documented and performed by licensed professionals in Ann Arbor, Michigan, following CMS guidelines.
Controlled Substance Monitoring & Lab Services
When managing addiction treatment, especially MAT (Medication-Assisted Treatment), providers often use:
- CPT 80305–80307: Drug testing codes (presumptive)
Medicare limits to 12 tests per patient/year unless medically justified
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HCPCS G0480–G0483: Definitive drug testing based on substance count
These services are essential in Ann Arbor, Michigan opioid treatment programs and office-based care.
Opioid Treatment Program (OTP) Billing
OTP services are billed using G codes and include medication, therapy, and care coordination:
- G2067–G2083: Cover weekly bundled services for methadone, buprenorphine, and naltrexone
- G2076: Intake session (including audio-only visits if video is unavailable)
Clinics in Ann Arbor, Michigan must document dosage, take-home status, and therapy time each week.
Social Determinants of Health (SDOH) Codes
CMS has added new codes to support services that help patients with needs like housing, food, and transportation. These include Community Health Integration (CHI) and Principal Illness Navigation (PIN). However, only providers in Ann Arbor, Michigan who can bill Evaluation and Management (E/M) codes or psychologists can use these codes. MHCs and MFTs in Ann Arbor, Michigan are not allowed to bill for these services.
Expanded CMS Guidelines
As of January 1, 2024, CMS allows Mental Health Counselors (MHCs) and Marriage and Family Therapists (MFTs) to enroll in Medicare and provide SUD treatment in Ann Arbor, Michigan. They must have a master’s or doctoral degree, a valid Michigan license, and at least 3,000 hours of supervised clinical experience. These providers are reimbursed at 80% of 75% of the Medicare fee schedule, which is lower than what other non-physician providers receive.
Is Inaccurate SUD Billing Putting Your Reimbursements at Risk?
Every denied claim and coding error in Ann Arbor, Michigan means lost revenue for providers and delayed care for patients.
Coordination of Benefits Confusion
SUD patients in Ann Arbor, Michigan often have multiple or changing insurance policies. Identifying the correct primary payer is crucial but complicated. Without proper coordination, claims are delayed, duplicated, or denied. This can disrupt payments and complicate financial operations for providers.
High Claim Denial Rates
As compared to other services, SUD billing in Ann Arbor, Michigan faces higher denial rates. These stem from inconsistent documentation, authorization issues, and payer-specific rules. Without targeted billing strategies, providers risk losing a large portion of legitimate reimbursements.
Lack of Specialized Billing Expertise
Many facilities in Ann Arbor, Michigan rely on general billing staff unfamiliar with SUD coding and payer expectations. This often leads to preventable errors and lost income. Outsourcing SUD billing and coding to experts can help close these gaps and capture missed revenue.
Inconsistent Payer Requirements
In Ann Arbor, Michigan, SUD billing is complicated by varying payer rules for services, documentation, authorizations, and billing codes. Each insurer may define medical necessity differently or limit covered treatments. It is important to deal with these inconsistencies, which require ongoing payer research to avoid denials and delayed payments.
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Key Statistics
Denial Rate Without Expert Billing – 15–20%
Revenue Loss from In-House Billing – Up to 30%
SUD Services Delivered via Telehealth in Ann Arbor, Michigan – 45%
Claim Delay Due to Authorization Errors – 14–21 Days
Why Substance Abuse Treatment Providers in Ann Arbor, Michigan Trust 24/7 Medical Billing Services
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Compliant Group Therapy Billing
Our billing experts guide providers in Ann Arbor, Michigan on payer-specific documentation standards for group therapy, including required details like session type, group size, and duration. This ensures clinical notes align with billing codes to prevent denials and support audit-ready submissions.
Correct Coding for All Forms
24/7 Medical Billing Services supports providers in Ann Arbor, Michigan by applying the correct HCPCS and CPT codes for MAT services. This helps in accurate coding of oral vs. injectable medications and includes required counseling services to avoid denials and maximize reimbursement.
Accurate Handling of Billed Services
Our billing professionals educate providers in Ann Arbor, Michigan on which SUD services should be bundled under payer contracts. We help prevent compliance errors by correctly grouping assessments, labs, and therapy based on coverage rules and avoid unintentional overbilling.
Payer-Compliant Drug Testing Billing
We help SUD providers in Michigan navigate payer-specific policies for drug screening, including frequency limitations and coding guidelines. Our team ensures clinical justification is clearly documented for each test billed to minimize denials due to overuse or insufficient medical necessity.
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Faster Reimbursements for Critical Behavioral Health Treatments!
Why Choose 24/7 Medical Billing Services for SUD Billing in Ann Arbor, Michigan?
24/7 Medical Billing Services specializes in handling the complex and evolving requirements of SUD billing in Ann Arbor, Michigan. Our solutions integrate cutting-edge RCM tools, denial tracking, HIPAA-compliant technology, and many more. This makes us the trusted outsourced partner for addiction treatment providers. Outsource SUD Billing Services Provider in Ann Arbor, Michigan to improve operational efficiency and elevate your billing performance while providing substance abuse disorder treatment services.
Real-Time Claim Tracking
You can track every claim from submission to payment with real-time dashboards and alerts. Our SUD billers and coders in Ann Arbor, Michigan offer transparency into delays, denials, and payer-specific issues. This allows for timely interventions and strategic decision-making based on up-to-the-minute billing performance metrics.
High First-Pass Rate
Our 95%+ clean claims rate means faster approvals and fewer rejections. We use automation, scrubbers, and compliance checkpoints to ensure your claims are accurate, payer-ready, and error-free. This helps SUD programs in Ann Arbor, Michigan avoid revenue loss and time-consuming rework.
Transparent Reporting
Our experts in Ann Arbor, Michigan provide access to detailed, customizable reports on collections, AR, denials, and payer trends. As a result, you can receive regular insights into performance, identifying bottlenecks and opportunities for improvement. This empowers you to take control of your financial data and optimize your revenue cycle.
Technology-Powered Efficiency
As a top medical billing and coding services company in Ann Arbor, Michigan, we deploy robotic process automation, HL7 integration, and EHR-friendly billing workflows. You can benefit from seamless billing processes, fewer manual errors, and greater operational efficiency. All this is possible without the need to purchase or manage complex, expensive billing software themselves.
99.99% Clean Claims and 100% Payouts for SUD Services in Ann Arbor, Michigan
Our SUD billing experts ensure precise coding and complete documentation to reduce denials and speed up approvals. Trust our billing team to keep your revenue flowing and your focus on treating SUD patients.
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FAQs
Is SUD billing allowed for LCSWs and LPCs in Ann Arbor, Michigan?
Yes, if credentialed with the payer and authorized to bill independently.
Are drug screenings required for SUD billing compliance in Ann Arbor, Michigan?
Not always, but they support ongoing treatment necessity.
Are there limits on billing SUD therapy per week in Michigan?
It depends on payer-specific utilization guidelines.
Can I bill for a no-show appointment in Ann Arbor, Michigan?
Only if the payer policy and state guidelines permit billing for missed visits.
Can SUD services be billed retroactively in Ann Arbor, Michigan?
Yes, within the payer’s timely filing limits, usually 90–180 days from the date of service.