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.