CPT-Not so Easy

The launch of the new CPT codes has not been so easy for many providers. The issues are being identified across the country and APA is investigating many outstanding issues. These are the major problems we are finding:

– BCBS is not processing claims yet so they may be violating prompt pay laws. In NY it is 45 days.

-There have been some significant rate reductions in connection with the new codes.

-Some companies are paying the same rate for 90834 and 90837.

UBH is requiring pre auth for 90837.

Please let me know if there are additional code related issues.


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One Response to CPT-Not so Easy

  1. Jerry-
    We’ve yet to receive $1 or EOB from VO/MVP for any 2013 sessions – when called they just say they’re having problems with the conversion – “could be 2-3 weeks more.” All the companies seem to be dragging their feet, and paying less, and inconsistent about whether paying the 90837 or 90834 – even Optum pays a few 90837’s, then not, although we’ve resubmitted everything as 90834. Even CDPHP, which was good intially, all of a sudden is slow with payments, with none this week. Very discouraging, and causing some hardship, to say the least.
    Thanks for all you’re doing.
    -Steve Altshuler

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