Substance Abuse Disorder Billing Services

Trusted Substance Abuse Disorder Billing Services in Huntsville, Alabama

Substance Use Disorder continues to be a major public health concern in the United States, affecting people across all age groups, income levels, and communities. It refers to the recurrent and harmful use of substances such as alcohol, opioids, or prescription drugs, leading to significant impairment in daily life. According to the National Survey on Drug Use and Health (NSDUH), over 46 million Americans aged 12 or older had an SUD in the past year, yet a large percentage did not receive treatment.

With the increasing demand for addiction recovery services, Substance Abuse Disorder Billing Services in Huntsville, Alabama plays a critical role in ensuring healthcare providers are properly reimbursed. SUD billing is not simply about submitting insurance claims, but requires careful documentation, accurate coding, and strict compliance with healthcare laws and payer rules. As treatment often involves ongoing sessions, bundled services, and medication management, billing can quickly become complicated.

Providers must use specific ICD-10-CM codes to document the type of substance used and the condition’s severity (e.g., abuse, dependence, withdrawal). Similarly, CPT and HCPCS codes must accurately reflect the procedures or services delivered, such as individual therapy, group sessions, lab testing, or telehealth encounters. Also, compliance with HIPAA and 42 CFR Part 2 is vital in safeguarding patient confidentiality. 

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Billing and Coding Guidelines for Substance Use Disorder 

Reliable Coding. Prompt Reimbursements. Better Support for SUD Recovery in Huntsville, Alabama

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 Huntsville, Alabama enhance claim precision and minimize denials.

CPT Code Selection 

Accurate CPT coding enables providers in Huntsville, Alabama 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 Huntsville, Alabama 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 Huntsville, Alabama, 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 Huntsville, Alabama, 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 Huntsville, Alabama 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 Huntsville, Alabama.

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 Huntsville, Alabama 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 Huntsville, Alabama 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 Huntsville, Alabama. The eligible providers must:

  • Hold a master’s or doctoral degree
  • Possess a valid Alabama 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 System Costing You Patients and Payments?

Missed reimbursements and billing mistakes in Huntsville, Alabama create serious setbacks for both patients and providers.

Inadequate Clinical Documentation Standards

Different payers in Alabama require detailed documentation for SUD services, including therapy notes and medical necessity. In fact, missing information often leads to rejections. In Huntsville, treatment centers face revenue losses when documentation doesn’t fully support the services billed.

Patient Collections During Recovery

In Huntsville, Alabama, collecting payments from patients in recovery is particularly sensitive. High deductibles and limited coverage make financial discussions difficult. Providers need compassionate communication and flexible plans to ensure compliance while maintaining trust during this vulnerable stage of treatment.

Strict Confidentiality Requirements 

Billing for SUD in Huntsville, Alabama must comply with strict federal privacy laws like 42 CFR Part 2. These rules limit what can be shared, which makes it harder to submit complete claims. Providers must balance compliance with payers’ documentation demands.

Frequent Denials 

Even small documentation errors can lead to frequent SUD claim denials. Missing progress notes, service details, or diagnosis codes delays reimbursement. Addressing these issues requires consistent charting practices and strong communication between clinical and billing teams.

Frustrated with mounting denials and confusing SUD billing rules? 

Get our expert support and advice in Huntsville, Alabama!

Speak to our Experts on

+1 888-502-0537

End-to-End Medical Billing Services provider across entire US.

Key Statistics

Denial Rate Without Expert Billing – 15–20%

Revenue Loss from In-House Billing – Up to 30%

SUD Services Delivered via Telehealth in Huntsville, Alabama – 45%

Claim Delay Due to Authorization Errors – 14–21 Days

Why Substance Abuse Treatment Providers in Huntsville, Alabama Trust 24/7 Medical Billing Services 

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

Timely Authorizations

Our billing experts work closely with clinical teams in Huntsville, Alabama 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 Huntsville, Alabama. 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 Huntsville, Alabama. 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 Huntsville, Alabama. 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 Huntsville, Alabama?

24/7 Medical Billing Services offers specialized billing solutions for SUD treatment providers in Huntsville, Alabama. Our dedicated team understands the sensitive nature and billing complexity of SUD care, including the unique payer rules, codes, and compliance demands that make in-house billing difficult. With our deep industry knowledge, we help providers eliminate denials, improve reimbursements, and maintain compliance. You can outsource SUD Billing Services Provider in Huntsville, Alabama to meet your unique clinical and compliance requirements.

Fast-Track Payments

When SUD billing is accurately coded and documented, up to 30% of claims are eligible for faster reimbursement. Our team uses intelligent claim tracking systems and payer-specific rules to reduce delays. This helps your practice in Huntsville, Alabama to maintain a stable cash flow.

End-to-End Expertise

As a top medical billing and coding company  in Huntsville, Alabama, we manage every stage of the billing process, from initial patient intake to post-treatment follow-up. Our billing professionals are trained to handle detox, MAT, outpatient care, and therapy claims with unmatched precision.

5-Day Follow-Up Promise 

Our experts guarantee follow-up on all accounts receivable within 5 business days. This disciplined approach guarantees providers in Huntsville, Alabama to minimize delays, shortens your revenue cycle, and keeps your cash flow consistent so you can stay focused on patient care.

Unmatched Data Security 

Your data is protected with HIPAA-compliant systems and adherence to 42 CFR Part 2 in Alabama. Our professionals use advanced encryption, secure submissions, and role-based access to safeguard sensitive SUD patient information at every stage of the billing cycle.

Maximize Reimbursements for Every Stage of Recovery Care in Huntsville, Alabama

Our SUD billing experts ensure accurate claims, reduced denials, and faster payments, so you can focus on helping patients heal. We handle it all with 24/7 claim tracking and follow-up from intake to aftercare.

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FAQs
Can mobile SUD units bill services in Huntsville, Alabama?

If the mobile setting is recognized by the payer.

Can I bill CPT 99406 for tobacco cessation in SUD care?

Yes, when used for counselling of 3–10 minutes.

How do I appeal a denied SUD claim in Huntsville, Alabama?

Submit corrected claim with supporting documentation per the payer's appeal process.

Can I bill the patient directly for non-covered SUD services in Huntsville, Alabama?

If an advance beneficiary notice or financial consent form was signed beforehand.

Are telehealth consents required for virtual SUD sessions?

Most payers and states require written or verbal telehealth consent documentation.

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