Cost
Decode the bill before you pay it.
Treatment bills are written in code. Here are the codes, and the lines that deserve a second look.
| Code | What it is | What to check |
|---|---|---|
| H0010 / H0011 | Detox, per day | Sub-acute or acute detox in a residential setting. |
| H0018 | Residential treatment, per day | Short-term residential, without room and board on some plans. |
| H0035 | Partial hospitalization, per day | A full day of programming. |
| H0015 | Intensive outpatient, per day | At least three hours of services. |
| 90837 | Individual therapy, 60 min | A session with a licensed therapist. |
| 90853 | Group therapy | Billed per person, per group. |
| 80305 / G0480 | Urine drug test | A cup test costs a few dollars. Lab "confirmation" panels can be billed in the hundreds or thousands. Frequent, expensive testing is the most abused line on a treatment bill. |
| Rev 1002 | Residential room and board | A facility code. Check that the dates match the days you were there. |
If the bill looks wrong
Five steps, in order
- Do not pay yet. Ask for the account to be put on hold while you review it.
- Ask the program for an itemized statement with billing codes and dates.
- Get the explanation of benefits (EOB) from your insurer for each claim and compare the two.
- Dispute errors in writing with the program, and appeal denials with your insurer.
- Ask about financial assistance, a prompt-pay discount or a payment plan. Bills are more negotiable than they look.
Want someone to look at it with you?
Compare notes with people who have fought the same bill.