#1 Substance Abuse Disorder Billing Services in Denver, Colorado

 

#1 Substance Abuse Disorder Billing Services in Denver, Colorado

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 Denver, Colorado, investing in Substance Abuse Disorder Billing Services in Denver, Colorado 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 

Reliable Coding. Prompt Reimbursements. Better Support for SUD Recovery in Denver, Colorado

Coding Systems and Diagnosis Representation

The proper use of ICD-10-CM codes is critical in billing for SUD. These codes help specify the type of substance involved and the nature of the issue. It can be abuse, dependency, withdrawal symptoms, or associated mental health episodes. The core codes include:

• 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 category can be refined based on the patient’s condition, for example, with intoxication, withdrawal, or in remission. Using the correct codes helps healthcare providers in Denver, Colorado enhance claim precision and minimize denials.

CPT Code Selection 

Accurate CPT coding enables providers in Denver, Colorado to clearly document the type and duration of services rendered. The commonly used CPT codes include:

• 90791, 90792: Psychiatric diagnostic assessments
• 90832, 90834, 90837: One-on-one psychotherapy (ranging from 30 to 60 minutes)
• 90846, 90847: Family-based therapy sessions
• 90853: Group therapy interventions
• 90863: Combined medication management with therapy
• 99408, 99409: Screening and short interventions for substance misuse
• G0396, G0397: Brief behavioral counseling sessions

Correctly applying these codes ensures the services are reflected appropriately on claims and that payment aligns with treatment complexity.

Bundled Codes for Office-Based SUD Treatment

CMS promotes the use of bundled G-codes for outpatient treatment of opioid and alcohol use disorders. These bundled payments cover multiple services delivered in a coordinated approach, including:

• G2086: 70 or more minutes of services during the initial month
• G2087: 60 or more minutes in each follow-up month
• G2088: Used for each additional 30 minutes of care provided

Outpatient clinics across Denver, Colorado rely on these codes to streamline reimbursement for integrated care models.

Preventive Screening and Brief Intervention

Identifying substance use risk early can prevent long-term complications. CMS supports this with specific billing codes for screening and brief behavioral interventions, especially in primary care. These include:

• G0442: Annual alcohol misuse screening (up to 15 minutes)
• G0443: In-person behavioral counseling (15 minutes)
• G0396: Counseling sessions ranging from 15–30 minutes
• G0397: Longer behavioral counseling (more than 30 minutes)

To bill these services in Denver, Colorado, providers must document time spent and patient risk factors clearly.

Safety Planning and Follow-Up Services

To prevent suicide or overdose-related emergencies, Medicare allows billing for preventive and follow-up interventions:

• G0560: Safety plans for individuals facing a crisis
• G0544: Follow-up contact after a recent overdose or critical event

These interventions should be carried out by licensed clinicians in Denver, Colorado, with thorough documentation aligned to CMS requirements.

Controlled Substance Monitoring & Lab Services

When treating SUD, especially through Medication-Assisted Treatment (MAT), regular drug testing is essential. The providers in Denver, Colorado use:

• CPT 80305–80307: For presumptive drug screening (capped at 12 tests annually per patient unless justified)
• HCPCS G0480–G0483: For definitive testing based on the number of substances tested

These codes support ongoing care and compliance monitoring in both outpatient and OTP settings.

Opioid Treatment Program (OTP) Billing 

Comprehensive care under the Opioid Treatment Program involves weekly bundled payments. The relevant codes include:

• G2067–G2083: Weekly bundles covering medication (like methadone or buprenorphine), therapy, and coordination
• G2076: Intake session (includes telehealth visits when video is unavailable)

Documentation must include therapy time, medication dose, and whether take-home privileges were granted for clinics in Denver, Colorado.

Social Determinants of Health (SDOH) Codes

CMS has introduced new codes aimed at supporting services that address non-medical needs such as housing, nutrition, and transportation. These include Community Health Integration (CHI) and Principal Illness Navigation (PIN). However, only providers in Denver, Colorado who are eligible to bill Evaluation and Management (E/M) codes or are licensed psychologists are authorized to use these codes. Mental Health Counselors (MHCs) and Marriage and Family Therapists (MFTs) in Denver, Colorado are not permitted to bill for these services.

Expanded CMS Guidelines

As of January 1, 2024, Mental Health Counselors (MHCs) and Marriage and Family Therapists (MFTs) are authorized to enroll in Medicare and treat SUD patients in Denver, Colorado. The eligible providers must:

• Hold a master’s or doctoral degree
• Possess a valid Colorado license
• Complete a minimum of 3,000 hours of supervised experience

These providers are reimbursed at 80% of 75% of the Medicare Physician Fee Schedule, lower than other non-physician practitioners.

 

Is your SUD Billing Costing you more than you Think?

Claim denials, coding confusion, and missed reimbursements hurt both providers and patients in Denver, Colorado.

Multimodal Treatment Billing Conflicts

SUD treatment in Denver, Colorado may include therapy, MAT, and group counseling provided simultaneously. Billing for these combined services can lead to payment issues and compliance problems without experienced medical billing providers. This requires careful coordination to ensure clean and accurate claims.

Conflicting Payer Views

Some insurers in Colorado may view substance use as a personal choice rather than a medical necessity. This stigma results in limited Medicare and Medicaid billing coverage, reduced reimbursement rates, and greater financial burden placed directly on patients seeking recovery services in Denver, Colorado.

Utilization Review Overload

Payers often require frequent utilization reviews (initial, concurrent, and retrospective). Managing these in Denver, Colorado demands constant updates and documentation. Missing even one review can result in denied claims and interrupted care.

Telehealth Billing Limitations

Virtual addiction treatment is growing in Denver, Colorado, but billing telehealth services requires using payer-specific codes, modifiers, and meeting strict documentation and privacy standards. Errors in any aspect can lead to denials or underpayment for legitimate tele-SUD services.

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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 Denver, Colorado – 45%

Claim Delay Due to Authorization Errors – 14–21 Days

 

Why Substance Abuse Treatment Providers in Denver, Colorado Trust 24/7 Medical Billing Services 

Streamline Claims and Maximize Reimbursements with the Best Outsourcing SUD Billing and Coding Company in Denver, Colorado!

Timely Authorizations

Our billing experts work closely with clinical teams in Denver, Colorado to anticipate care changes and proactively request authorizations. We ensure minimal disruption by aligning payer timelines with clinical adjustments, reducing claim denials, and maintaining continuity of SUD treatment coverage.

Precision ICD-10 Coding

Our certified coders specialize in behavioral health and apply the correct ICD-10 codes for SUD cases in Denver, Colorado. We ensure accurate, detailed coding for diagnoses and procedures, which minimizes denials and supports compliance with both Medicare and private payers.

Clear Documentation for Readmissions

Our billing experts assist providers in developing detailed documentation protocols that clearly establish medical necessity for SUD readmissions in Denver, Colorado. This helps reduce claim denials by ensuring that every readmission is justified with thorough clinical records and payer-specific language.

Seamless Authorization for Care Transitions

24/7 Medical Billing Services professionals streamline authorizations by tracking transitions between care levels in real time across facilities in Denver, Colorado. Our team coordinates closely with clinical staff to ensure timely submissions and reduce billing disruptions during every stage of SUD treatment.

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Precise SUD Claims for Critical Behavioral Health Treatments!

 

Why Choose 24/7 Medical Billing Services for SUD Billing in Denver, Colorado?

24/7 Medical Billing Services helps SUD providers in Denver, Colorado scale operations without increasing internal workload. Our agile billing model adapts to seasonal fluctuations, census changes, and new service lines. We offer full support for documentation compliance, payer-specific guidelines, and audit preparedness to help you remain fully compliant at every stage. Outsource SUD Billing Services Provider in Denver, Colorado to stay audit-ready, revenue-strong, and focused on patient recovery, not paperwork.

Built-In Scalability

Our flexible team adjusts to your growth and helps you manage new locations, programs, or patient surges without delays. As a result, providers in Denver, Colorado can avoid staffing gaps, onboarding delays, and administrative burdens by leveraging our flexible, always-ready billing capacity.

AR Management on Autopilot

As a top medical billing and coding company in Denver, Colorado, we follow up on aging claims within 5 business days and resolve denials efficiently. This proactive approach ensures consistent cash flow and supports financial stability for SUD centers in Denver, Colorado, even during high-volume or seasonal fluctuations in service demand.

Audit-Ready Compliance 

Our billing team maintains airtight documentation, payer policy updates, and regulatory alignment across all claims. This reduces audit risks for SUD practices in Denver, Colorado, and ensures compliance, security, and operational soundness, even during random payer reviews or government inspections.

Multi-Channel Support 

Our experts offer patient and provider support across phone, email, portal, and text, ensuring fast issue resolution. In Denver, Colorado, your staff and patients benefit from responsive, multi-lingual help that enhances satisfaction and minimizes billing-related disruptions to care delivery.

Keep Patient Recovery Moving with Reliable Billing in Denver, Colorado

Our SUD billing and coding support uninterrupted treatment by minimizing billing delays, reducing denials, and closing documentation gaps. 24/7 Medical Billing Services helps preserve patient access and improve overall care delivery from initial intake to long-term aftercare.

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FAQs

Is SUD billing allowed for LCSWs and LPCs in Denver, Colorado? 

Yes, if credentialed with the payer and authorized to bill independently.

Are drug screenings required for SUD billing compliance in Denver, Colorado?

Not always, but they support ongoing treatment necessity.

Are there limits on billing SUD therapy per week in Colorado?

It depends on payer-specific utilization guidelines.

Can I bill for a no-show appointment in Denver, Colorado?

Only if the payer policy and state guidelines permit billing for missed visits.

Can SUD services be billed retroactively in Denver, Colorado?

Yes, within the payer’s timely filing limits, usually 90–180 days from the date of service.