Best Substance Abuse Disorder Billing Services in Tempe, Arizona

 

Best Substance Abuse Disorder Billing Services in Tempe, Arizona

Millions of Americans are affected by SUDs, including alcohol and drug use disorders. These disorders can cause major health problems, damage personal relationships, lead to legal trouble, and disrupt daily life. Fortunately! Effective treatment options like counseling, behavioral therapies, and medication can support recovery and help individuals regain healthier, more stable lives.

To support recovery and improve access to care in Tempe, Arizona, and beyond, healthcare providers must be reimbursed for the services they deliver. This underlines the importance of accurate and efficient Substance Abuse Disorder Billing Services in Tempe, Arizona. Better billing leads to better access to care, better outcomes, and a stronger healthcare system for everyone affected by substance abuse. 

SUD billing is not only about submitting claims, but it involves the correct use of CPT and ICD-10 coding, compliance with 42 CFR Part 2 rules and HIPAA to protect patient privacy, and proper documentation. With the rise of telehealth in Tempe, it is also crucial for SUD providers to know that the same CPT codes are used as in-person visits. 

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Billing and Coding Guidelines for Substance Use Disorder 

Optimized Billing. Consistent Revenue. Better SUD Outcomes in Tempe, Arizona

Coding Systems and Diagnosis Representation

ICD-10-CM codes are critical in SUD billing as they define both the type of substance involved and the disorder’s clinical status, such as intoxication, withdrawal, or sustained remission. Each category allows further classification based on severity and associated symptoms:

• F10: Alcohol-related disorders (e.g., alcohol dependence with withdrawal)
• F11: Opioid-related disorders (e.g., opioid use disorder with intoxication)
• F12: Cannabis-related disorders (e.g., cannabis-induced psychosis)
• F13: Sedative, hypnotic, or anxiolytic-related disorders
• F14: Cocaine-related disorders
• F15: Disorders related to other stimulants (e.g., methamphetamine)
• F16: Hallucinogen-related disorders
• F17: Nicotine dependence (e.g., tobacco use disorder)
• F18: Inhalant-related disorders
• F19: Polysubstance use or unspecified substance disorders

Accurate diagnosis selection helps reduce claim denials and ensures precise documentation for providers operating in Tempe, Arizona.

CPT Code Selection 

CPT codes are used by practitioners to document the specific behavioral health services provided during an appointment. The codes commonly used include:

• 90791, 90792: Psychiatric diagnostic evaluation - used for initial mental health assessments
• 90832, 90834, 90837: Psychotherapy sessions - based on time: 30, 45, or 60 minutes
• 90846, 90847: Family therapy sessions - without or with the patient present, respectively
• 90853: Group therapy sessions - used for therapeutic sessions involving multiple patients
• 90863: Combined psychotherapy and medication management
• 99408, 99409: Screening and brief interventions - used for moderate to high-risk substance use
• G0396, G0397: Behavioral counselling - short (15–30 min) and extended (30+ min) sessions for alcohol or substance use

Bundled Codes for Office-Based SUD Treatment

CMS provides bundled G-codes for structured outpatient care involving multiple services for alcohol and opioid use disorders:

• G2086: First-month care with at least 70 minutes of services
• G2087: Ongoing monthly care with 60+ minutes of services
• G2088: Each additional 30 minutes of service beyond G2086/G2087

These codes allow for integrated reporting of counseling, care coordination, and treatment planning typically used by providers in Tempe, Arizona.

Preventive Screening and Brief Intervention

Early screening and brief interventions are essential in identifying individuals at risk for substance misuse. CMS supports reimbursement for:

• G0442: Annual screening for alcohol misuse (15 minutes)
• G0443: Face-to-face brief behavioral counseling (15 minutes)
• G0396: Short counseling sessions lasting 15–30 minutes
• G0397: Longer counseling sessions exceeding 30 minutes

These services require thorough documentation of time spent and risk assessment findings, often utilized in primary care or integrated care settings across Tempe, Arizona.

Safety Planning and Follow-Up Services

To address risks related to overdose or mental health crises, Medicare allows providers to bill for:

• G0560: Development of a safety plan for patients at risk of suicide or SUD-related crises
• G0544: Follow-up contact (in person or remote) after an overdose or critical incident

These services are performed by licensed professionals and must be supported by clear clinical documentation in Tempe, Arizona.

Controlled Substance Monitoring & Lab Services

Managing SUD, especially in MAT (Medication-Assisted Treatment), requires consistent monitoring of substance use. The relevant codes include:

• CPT 80305–80307: Presumptive drug testing - screening for drug classes using various lab technologies

Limited to 12 tests per year per patient under Medicare unless additional testing is medically necessary

• HCPCS G0480–G0483: Definitive drug testing - used for detailed identification of multiple substances

The level (G0480–G0483) varies based on the number of substances being tested

These codes are crucial for SUD treatment plans in clinics and opioid programs in Tempe, Arizona.

Opioid Treatment Program (OTP) Billing 

CMS requires the use of specific G-codes to bill for OTP services, which combine medication, therapy, and support services:

• G2067–G2083: Weekly bundled codes for methadone, buprenorphine, or naltrexone administration with counseling
• G2076: Initial intake and assessment session - also covers audio-only visits if video is unavailable

Clinics must document medication dosage, take-home doses, and weekly therapy sessions as part of the treatment plan in Tempe, Arizona.

Social Determinants of Health (SDOH) Codes

CMS recognizes that social and environmental factors influence recovery outcomes. The healthcare providers in Tempe, Arizona who bill Evaluation and Management (E/M) services or are licensed psychologists can bill for:

• Community Health Integration (CHI)
• Principal Illness Navigation (PIN)

These codes help support patients needing assistance with housing, food, transportation, etc. However, Mental Health Counselors (MHCs) and Marriage and Family Therapists (MFTs) in Tempe, Arizona currently cannot bill for these services under CMS rules.

Expanded CMS Guidelines

As of January 1, 2024, CMS permits MHCs and MFTs to enroll in Medicare and provide SUD-related services in Tempe, Arizona. To qualify, these professionals must meet the following criteria:

• Hold a master's or doctoral degree in behavioral health
• Possess a valid license from the Arizona
• Complete a minimum of 3,000 hours of supervised clinical experience

These providers are reimbursed at 80% of 75% of the Medicare Physician Fee Schedule, which is lower than other non-physician rates but still a significant step toward expanding access to care.

 

Are You Paying the Price for Inefficient SUD Billing Practices?

When SUD billing fails in Tempe, Arizona, providers lose income and patients lose access.

Group Therapy Billing Inconsistencies

SUD programs in Tempe, Arizona often deliver group therapy, but payer policies differ on how sessions should be billed. Inconsistent documentation on group size, duration, or session type can trigger denials. Providers must ensure alignment between clinical notes and billing requirements for group-based services.

MAT-Specific Coding Requirements

Billing for Medication-Assisted Treatment in Tempe, Arizona involves unique HCPCS and CPT codes depending on the drug, dosage, and delivery method. Errors in coding injectable vs. oral medication or failing to include related counseling services often result in underpayment or denied claims.

Bundled vs. Unbundled Service Confusion

SUD programs in Tempe, Arizona may unintentionally unbundle services that payers consider part of a package, such as combining assessments, drug testing, and therapy. This leads to compliance issues or payment denials. A clear understanding of bundled payment structures is essential in SUD billing.

Drug Testing Billing Restrictions

The frequent drug screenings are a key part of SUD care. But in Arizona, payer limitations on frequency, medical necessity, and code selection make billing challenging. Without precise documentation and justification, claims for urine drug screens may be flagged for overuse or denied altogether.

Struggling to keep up with complex SUD reimbursement rules in Tempe, Arizona?

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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 Tempe, Arizona – 45%

Claim Delay Due to Authorization Errors – 14–21 Days

 

Why Substance Abuse Treatment Providers in Tempe, Arizona Trust 24/7 Medical Billing Services 

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

Timely Authorizations

Our billing experts work closely with clinical teams in Tempe, Arizona 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 Tempe, Arizona. 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 Tempe, Arizona. 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 Tempe, Arizona. 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 Tempe, Arizona?

24/7 Medical Billing Services helps SUD providers in Tempe, Arizona 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 Tempe, Arizona 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 Tempe, Arizona 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 Tempe, Arizona, 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 Tempe, Arizona, 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 Tempe, Arizona, 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 Tempe, Arizona, 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 Tempe, Arizona

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

Can I bill group therapy and individual therapy on the same day in Tempe, Arizona?

If documentation supports both services separately and payers in Arizona allow it.

What are the ICD-10 codes for alcohol and drug dependency in Tempe, Arizona?

Codes range from F10 (alcohol) to F19 (multiple drug use), depending on the diagnosis specifics.

What is the difference between behavioral health billing and SUD billing?

SUD billing involves specialized codes, compliance laws, and payer policies unique to substance abuse treatment.

Can I bill for intake and assessment separately in Tempe, Arizona?

Codes like H0001 or 90791 are often used for separately billable SUD assessments.

What is the timely filing limit for SUD claims in Tempe, Arizona?

Most insurers in Arizona require claims to be submitted within 90–180 days from the date of service.