Since the 1998 CPT procedure codes are time-specific, providers need to use the time code applicable to the time spent in performing the service. Thus, choose the CPT code that most accurately reflects the time spent as well as the service provided. Bill time-specific codes 90804 through 90829 with a quantity of one. Wisconsin Medicaid requires that supporting documentation be submitted with a claim when providers use this code. The list includes the procedure code, description, who may provide the service, any limitations, allowable diagnoses, allowable type of service, and allowable place of service.
Providers determine their usual and customary charges.
Providers are reimbursed at the lesser of their billed amount or the maximum allowable fee. Since the 1998 CPT procedure codes are time-specific, providers need to use the time code applicable to the time spent in performing the service. Reimbursement Wisconsin Medicaid's hourly reimbursement rate is not affected by the new codes presented in this Update. Medicaid reimbursement for the new procedure codes is based on the same hourly rate that was paid previously. Wisconsin Medicaid's hourly reimbursement rate is not affected by the new codes presented in this Update.