Auto-Placement by Service Code
This feature is enabled and managed by Payers (MCOs) and available to Members of a participating Payer network. To determine eligibility, the Member’s Medicaid ID and/or the First Name, Last Name, and DOB must match the Payer system.
The Auto-Placement by Service Code feature allows Providers to schedule and bill for services that do not require prior Payer authorization. When this feature is enabled by the Payer, the Allow Auto Placement checkbox field displays selected in the Contract Service Code window under Admin > Reference Table Management > Contract Service Code as read-only.
Payers provide a list of eligible Service Codes that can be used to perform an Auto Placement. Once the Service Code is created and synced from the Payer system, Providers can create a new contract for a Patient.
Complete the following steps to create an Auto Placement for a Member.
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Go to Member > Member Search to locate the Member.
If a Member does not exist in the system, then go to Member > New Member to create a New Member Profile.
The Medicaid Number MUST be entered for a successful placement.
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Select the Contracts link from the index to open the Contracts page. On the Contracts page, click the Add button to add a contract.
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On the Contracts window, complete the required fields (Contract and Service Start Date) as well as the optional fields to include the applicable Service Code. Click Save.
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Once saved, the Contract appears in the Contract page, pending the Alt. Patient ID. Allow a few seconds, for the system to refresh. Click the Refresh Page button to refresh, as needed.
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A populated Alt. Patient ID indicates a successful auto placement. When an auto placement is submitted, the system validates the Patient information (such as Patient Name, Medicaid ID, etc.) against the Payer Member data. Once verified, a placement confirmation is sent to the Provider.
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If a diagnosis code is required on the claim, then add it on the Patient contract or on the invoice.
Payer Eligible Service Codes
The following tables include the eligible Service Codes per participating Payer.
Diagnosis Code must be added to Patient contract.
Service Code |
Description |
Service Code |
Description |
---|---|---|---|
92551 |
Screening Test, Pure Tone, Air Only |
G0153 |
Speech Therapy (Day 1-28) by a ST |
92552 |
Pure tone audiometry (threshold); Air Only |
G0153UD |
Speech Therapy (Day 29 and beyond) by a ST |
99500AT |
Home Visit Prenatal (Non HBP) Assessment |
G0154 |
HHCP - Svs of RN, EA 15 Mins |
99501AT |
Home Visit Postnatal (Non HBP) Follow-up Care |
G0155 |
Social Worker |
99501ATGT |
Home Visit Postnatal (Non HBP) Follow-up Care Audio/Video |
G0299 |
Dir SNS RN HH/Hospice Set |
G0108 |
Diabetes Outpatient Training Service, individual |
G0299UB |
Dir SNS RN HH/Hospice Set - UB |
G0109 |
Diabetes Outpatient Training, group |
G0299U8 |
HHA visit to a patient's home (Day 1-28) by a RN |
G0151 |
Physical Therapy (Day 1-28) by a PT |
G0299U8UD |
HHA visit to patient's home (Day 29 and beyond) by a RN |
G0151UD |
Physical Therapy (Day 29 and beyond) by a PT |
G0300U8 |
HHA visit to a patient's home (Day 1-28) by a LPN |
G0151U8 |
HHCP-SERV OF PT, EA 15 Mins |
G0300U8UD |
HHA visit to patient's home (Day 29 and beyond) by a LPN |
G0152 |
Occupational Therapy (Day 1-28) by an OT |
G0300 |
Dir SNS LPN HH/Hospice Set |
G0152UD |
Occupational Therapy (Day 29 and beyond) by an OT |
G0300UB |
Dir SNS LPN HH/Hospice Set - UB |
G0152U8 |
HHCP-SERV OF OT, EA 15 Mins |
Diagnosis Code must be added to Patient contract.
Service Code |
Description |
Service Code |
Description |
---|---|---|---|
97161 |
PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS |
97165 |
OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS |
G0151 | Physical Therapy | G0152 | SRVC OT HOM HLTH/HOSPICE EA 15 MIN |
G0157 | PT Assistant | G0158 | SRVC OT ASSIST HH/HOSPICE EA 15 MIN |
G0159 RC420 | SRVC PT HH EST/DEL PT MP EA 15 MINS | G0160 RC430 | SRVC OT HH EST/DEL OT MP EA 15 MIN |
G0159 RC424 | SRVC PT HH EST/DEL PT MP EA 15 MINS | G0160 RC434 | SRVC OT HH EST/DEL OT MP EA 15 MIN |
92521 | EVALUATION OF SPEECH FLUENCY | G0153 | SRVC SPCHANDLANG PATH HH/HOSPIC EA 15 |
92522 | EVALUATE SPEECH PRODUCTION | G0161 | SRVC SLP HH EST/DEL SLP TX MP 15 MN |
92523 | SPEECH SOUND LANG COMPREHEN | G0283 | E-STIM 1/>NOT WND CARE PART TX PLAN |
97162 | PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS | G2168 | Services performed by minutes |
97163 | PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS | G2169 | SERVICES PRFRM BY OT ASST HH SETTING EA 15 MIN |
97164 | PHYSICAL THERAPY RE-EVAL EST PLAN CARE 20 MINS | S9128 | SPEECH THERAPY IN THE HOME PER DIEM |
97166 | OCCUPATIONAL THERAPY EVAL MOD COMPLEX 45 MINS | S9129 | OCCUPATIONAL THERAPY HOME PER DIEM |
97167 |
OCCUPATIONAL THERAPY EVAL HIGH COMPLEX 60 MINS |
S9131 |
PHYSICAL THERAPY HOME PER DIEM |
97168 | OCCUPATIONAL THER RE-EVAL EST PLAN CARE 30 MINS |
Diagnosis Code must be added to the Invoice Details page.
Service Code |
Description |
Service Code |
Description |
---|---|---|---|
G0159 |
SRVC PT HH EST/DEL PT MP EA 15 MINS |
G0162 |
SKILLED SRVC RN MANDE POC EA 15 MINS |
G0160 |
SRVC OT HH EST/DEL OT MP EA 15 MIN |
G0493 |
RN CARE EA 15 MIN HH/HOSPICE |
G0161 |
SRVC SLP HH EST/DEL SLP TX MP 15 MN |
G0494 |
LPN CARE EA 15MIN HH/HOSPICE |
Diagnosis Code must be added to Patient contract.
Service Code |
Description |
Service Code |
Description |
---|---|---|---|
92551 |
Screening Test, Pure Tone, Air Only |
G0153 |
Speech Therapy (Day 1-28) by a ST |
92552 |
Pure tone audiometry (threshold); Air Only |
G0153UD |
Speech Therapy (Day 29 and beyond) by a ST |
99500AT |
Home Visit Prenatal (Non HBP) Assessment |
G0154 |
HHCP - Svs of RN, EA 15 Mins |
99501AT |
Home Visit Postnatal (Non HBP) Follow-up Care |
G0155 |
Social Worker |
99501ATGT |
Home Visit Postnatal (Non HBP) Follow-up Care Audio/Video |
G0299 |
Dir SNS RN HH/Hospice Set |
G0108 |
Diabetes Outpatient Training Service, individual |
G0299UB |
Dir SNS RN HH/Hospice Set - UB |
G0109 |
Diabetes Outpatient Training, group |
G0299U8 |
HHA visit to a patient's home (Day 1-28) by a RN |
G0151 |
Physical Therapy (Day 1-28) by a PT |
G0299U8UD |
HHA visit to patient's home (Day 29 and beyond) by a RN |
G0151UD |
Physical Therapy (Day 29 and beyond) by a PT |
G0300U8 |
HHA visit to a patient's home (Day 1-28) by a LPN |
G0151U8 |
HHCP-SERV OF PT, EA 15 Mins |
G0300U8UD |
HHA visit to patient's home (Day 29 and beyond) by a LPN |
G0152 |
Occupational Therapy (Day 1-28) by an OT |
G0300 |
Dir SNS LPN HH/Hospice Set |
G0152UD |
Occupational Therapy (Day 29 and beyond) by an OT |
G0300UB |
Dir SNS LPN HH/Hospice Set - UB |
G0152U8 |
HHCP-SERV OF OT,EA 15 Mins |
Diagnosis Code must be added to Patient contract.
Service Code |
Description |
Service Code |
Description |
---|---|---|---|
92551 |
Screening Test, Pure Tone, Air Only |
G0153 |
Speech Therapy (Day 1-28) by a ST |
92552 |
Pure tone audiometry (threshold); Air Only |
G0153:UD |
Speech Therapy (Day 29 and beyond) by a ST |
99500:AT |
Home Visit Prenatal (Non HBP) Assessment |
G0154 |
HHCP - Svs of RN, EA 15 Mins |
99501:AT |
Home Visit Postnatal (Non HBP) Follow-up Care |
G0155 |
Social Worker |
99501:AT:GT |
Home Visit Postnatal (Non HBP) Follow-up Care Audio/Video |
S9127 |
Social Work Visit, In the Home, Per Diem |
G0108 |
Diabetes Outpatient Training Service, individual |
S9128 |
Speech Therapy, In the Home |
G0109 |
Diabetes Outpatient Training, group |
S9129 |
Occupational Therapy, In the Home |
G0151 |
Physical Therapy (Day 1-28) by a PT |
S9131 |
Physical Therapy, In the Home |
G0151:UD |
Physical Therapy (Day 29 and beyond) by a PT |
T2025:GN |
Speech/Language Therapy-15 Mins |
G0151:U8 |
HHCP-SERV OF PT, EA 15 Mins |
T2025:GO |
Occupational Therapy-15 Mins |
G0152 |
Occupational Therapy (Day 1-28) by an OT |
T2025:GO:U4 |
Home Health - Occupational Therapy Assist. |
G0152:UD |
Occupational Therapy (Day 29 and beyond) by an OT |
T2025:GP |
Physical Therapy-15 Mins |
G0152:U8 |
HHCP-SERV OF OT, EA 15 Mins |
T2025:GP:U4 |
Physical Therapy Assistant -15 Mins |
Diagnosis Code must be added to Patient contract.
Service Code |
Description |
Service Code |
Description |
---|---|---|---|
92551 |
Screening Test, Pure Tone, Air Only |
G0156AT |
Aide in Home Health or Hospice - 15 Mins - AT |
92552 |
Pure tone audiometry (threshold); Air Only |
G0156TT |
Aide in Home Health or Hospice - 15 Mins - TT |
99500AT |
Home Visit Prenatal (Non HBP) Assessment |
G0156U8 |
HHA visit to patient's home (Day 1-28) by a HH Aide |
99501AT |
Home Visit Postnatal (Non HBP) Follow-up Care |
G0156U8UD |
HHA visit to patient's home (Day 29 and beyond) by a HH Aide |
99501ATGT |
Home Visit Postnatal (Non HBP) Follow-up Care Audio/Video |
G0156U9 |
Aide in Home Health or Hospice - 15 Mins - U9 |
G0108 |
Diabetes Outpatient Training Service, individual |
G0156UD |
Aide in Home Health or Hospice - 15 Mins - UD |
G0109 |
Diabetes Outpatient Training, group |
G0299 |
Dir SNS RN HH/Hospice Set |
G0151 |
Physical Therapy (Day 1-28) by a PT |
G0299U8 |
HHA visit to a patient's home (Day 1-28) by a RN |
G0151U8 |
HHCP-SERV OF PT, EA 15 Mins |
G0299U8UD |
HHA visit to patient's home (Day 29 and beyond) by a RN |
G0151UD |
Physical Therapy (Day 29 and beyond) by a PT |
G0299UB |
Dir SNS RN HH/Hospice Set - UB |
G0152 |
Occupational Therapy (Day 1-28) by an OT |
G0300 |
Dir SNS LPN HH/Hospice Set |
G0152U8 |
HHCP-SERV OF OT, EA 15 Mins |
G0300U8 |
HHA visit to a patient's home (Day 1-28) by a LPN |
G0152UD |
Occupational Therapy (Day 29 and beyond) by an OT |
G0300U8UD |
HHA visit to patient's home (Day 29 and beyond) by a LPN |
G0153 |
Speech Therapy (Day 1-28) by a ST |
G0300UB |
Dir SNS LPN HH/Hospice Set - UB |
G0153UD |
Speech Therapy (Day 29 and beyond) by a ST |
S9127 |
Social Work Visit, In the Home, Per Diem |
G0154 |
HHCP - Svs of RN, EA 15 Mins |
S9128 |
Speech Therapy, In the Home |
G0155 |
Social Worker |
S9129 |
Occupational Therapy, In the Home |
G0156 |
Aide in Home Health or Hospice - 15 Mins |
S9131 |
Physical Therapy, In the Home |