Certain Medicaid and private carriers will pay claims for treat-and-release services, the same way the ET3 program once intended, using HCPCS G2021 and G2022.
Some state Medicaid carriers, and some private carriers too, will pay claims for BLS/ALS treat-and-release, and sometimes even for refusals.
First, Check Their Companion Guide
Every carrier, including the state Medicaid carriers, publishes a companion guide explaining how to code these special claims.
If the companion guide does not mention treat-and-release, or HCPCS codes G2021 and G2022, then they don't cover it.
Companion guides are notoriously technical, and hard to read. Most people need some assistance in reading one. Please do not call AngelTrack Support for this purpose, as we are forbidden from giving billing advice.
Prerequisites
The servicing crew must have been capable -- on the date of service -- of providing BLS or ALS care. You are probably not allowed to claim treat-and-release care given by a wheelchair-van or gurney-van driver.
During QA review, the reviewer will see that no transport was provided. She should nevertheless mark the trip as BLS or ALS, according to the qualifications of the crew and their vehicle. This is necessary not just for the subsequent coding, but also to engage AngelTrack's price schedules for BLS and ALS visits. Remember that the visit price still applies, even if the mileage price is inapplicable, and therefore a catch-and-release call should be QA'd as BLS or ALS according to what level of transport could've been provided if necessary.
Setting Up the Claim
The following advice is for creating an ET3-style claim for treat-and-release. Not all carriers follow ET3's example, so your mileage may vary.
When you code the claim, select BLS (A0428/A0429) or ALS (A0426/A0427) as appropriate. Probably the carrier will not pay catch-and-release unless it was emergent, so A0429 and A0427 might be the only options.
For the location modifier, they will probably want RR, RW, SS, SW, or EW, but check the companion guide to be sure.
There won't be any claim for mileage (A0425).
You must then add an additional service to the claim, by clicking "Add non-standard service codes" in AngelTrack's coding page. The purpose of this additional service is informational, to tell the carrier that it was treat-and-release.
Add this informational service claim for a successful treat-in-place:
- HCPCS code G2021 "Health care practice treatment in place"
- Price $0.01
- Quantity 1
- Modifier EW, RW, or SW
...or this one for a refusal of treat-in-place / refusal-release:
- HCPCS code G2022 "Beneficiary refuses service"
- Price $0.01
- Quantity 1
- Leave the modifier blank
The carrier won't pay anything against G2021 and G2022, instead the benefits will be paid against the claim for A042x.