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West Virginia Office of
Emergency Medical Services

350 Capitol Street
Room 425
Charleston WV, 25301

Toll Free: 1-888--747-8367
OEMS Phone: (304) 558-3956
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Trauma Phone: (304) 558-7124
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Reminder:EMS Billing Codes For Suspected Overdose

While the information contained in this news article was current and accurate when we posted it, it may not necessarily represent current WVOEMS policy or procedure. If you have any questions, please contact our office at 304-558-3956.

Posted: Tuesday, August 28, 2018 9:57 AM

The Bureau for Medical Services would like to remind all EMS first responders of the two new billing codes that were opened through the SUD Waiver program on January 14, 2018.  These codes are specifically for EMS first responders serving West Virginia Medicaid members with a suspected overdose.  The two new services are Naloxone Administered by EMS (A00998) and Referral to Treatment by EMS (H0050).  You can bill for the administering of Naloxone regardless if the member is transported to the ER or not.  Similarly, you can bill for the Referral to Treatment by EMS as long as information is shared with the member about the availability of local SUD services and/or the 1-844-HELP4WV helpline, regardless if the member agrees to seek treatment or not.

Many departments have received the Naloxone kits that are supplied through grant-funding. You cannot bill Medicaid for any Naloxone kits administered that you received through grant-funding.  

However, even if you administered a grant-funded naloxone kit, you could still bill for the Referral to Treatment by EMS (H0050) if you provided the service by sharing information about or making a referral to treatment to local SUD service providers or the 1-844-HELP4WV helpline.  

The information about these two new services can be found in Chapter 504 of the West Virginia Medicaid Providers Manual located here: https://dhhr.wv.gov/bms/Provider/Documents/Manuals/Chapter%20504%20Substance%20Use%20Disorder%20Services%20Manual%20FINALwithoutwatermark.pdf

 

The WV Helpline may be reached at 1-844-HELP4WV (1-844-435-7498). HELP4WV offers a 24/7 call, chat, and text line that provides immediate help for any West Virginian struggling with an addiction or mental health issue. Many of those answering the helpline are peer-support specialists or recovery coaches. This means that they have personal experience in recovery from a mental health or substance abuse issue. The helpline staff offers confidential support and resource referrals, including self-help groups, outpatient counseling, medication-assisted treatment, psychiatric care, emergency care, and residential treatment. If the member is not interested in a referral to treatment at this time, the prehospital provider leaves the information with the member.

If you have any questions about these services, please contact Jeffrey S. Lane, SUD Waiver Program Manager at Jeffrey.S.Lane@wv.gov or by calling (304) 356-5264.

 

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