Hello,For an approved OTP provider - g2067 is the weekly bundled rate which includes the medication. G2078 is the additional -up to a 7 day supply that can be billed . You cannot bill the G2078 more than 3 units per month. Billing can look like this monthly ( 4 weeks) , provided the services were given:
Week 1 G2067
G2078 x 3
week 2 g2074
week 3 g2074
week 4 g2074
or
week 1 G2067
G2078 x1
week 2 G2067
week 3 G2067
week 4 G2074
Thank you!To bill Medicare for the G codes you must be a Medicare enrolled OTP provider then you MUST use the bundled codes per MLN8296732. We have a lot of clients/patients that we bill for this service. If they dose daily or have a 1 week take home we bill G2067 or G2068 (meth/buph) It is billed each week with the dos as a sunday usually...i think it makes it easier doing it that day. (ie 01/29/2023-G2067 (1 unit), 02/05/2023-G2067 (1 unit)) If the client has a two week take home of methadone we bill G2067 & G2078 (bundle with medication/extra 7 days of medication) every two weeks. If they come in the week in between and have counseling, UDS or group then you bill G2074 (bundle with no medication) but only if they have services..if they do not come in for any services then you bill nothing that week.
So my billing would look like this for daily or weekly dosing:
01/08/2023 G2067 1 unit (this includes counseling, uds, group, etc) if they have a dr appt you can bill a G2077 as an add on code
01/15/2023 G2067 1 unit
01/22/2023 G2067 1 unit
Billing for a two week take home dosing:
01/08/2023 G2067 & G2078 1 unit each
01/15/2023 no services nothing billed
01/22/2023 G2067 & G2078 1 unit each
01/31/2022 G2074 (client had group and individual counseling)
To bill Medicare for the G codes you must be a Medicare enrolled OTP provider then you MUST use the bundled codes per MLN8296732. We have a lot of clients/patients that we bill for this service. If they dose daily or have a 1 week take home we bill G2067 or G2068 (meth/buph) It is billed each week with the dos as a sunday usually...i think it makes it easier doing it that day. (ie 01/29/2023-G2067 (1 unit), 02/05/2023-G2067 (1 unit)) If the client has a two week take home of methadone we bill G2067 & G2078 (bundle with medication/extra 7 days of medication) every two weeks. If they come in the week in between and have counseling, UDS or group then you bill G2074 (bundle with no medication) but only if they have services..if they do not come in for any services then you bill nothing that week.
So my billing would look like this for daily or weekly dosing:
01/08/2023 G2067 1 unit (this includes counseling, uds, group, etc) if they have a dr appt you can bill a G2077 as an add on code
01/15/2023 G2067 1 unit
01/22/2023 G2067 1 unit
Billing for a two week take home dosing:
01/08/2023 G2067 & G2078 1 unit each
01/15/2023 no services nothing billed
01/22/2023 G2067 & G2078 1 unit each
01/31/2022 G2074 (client had group and individual counseling)