Welcome Providers!

News

Effective January 1, 2013, the Psychiatry section of the CPT manual published by the American Medical Association (AMA) was revised. A number of frequently used behavioral health codes were deleted. New codes were added and must be used for billing and documentation for all carriers.
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We now provide an on-line tool for you to simulate code combinations with the ability to view and edit results and rationales. You will be able to enter procedure codes, modifiers, diagnosis codes, date of service, patient gender, date of birth and place of service parameters, in order to review results specific to the procedure codes being queried.
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FAQ for WI Autism Spectrum Disorder Mandate:

• Are you an Autism Qualified Provider?
  Please refer to the Ins 3.36, Wis Adm. Code – EmR0923
• Frequently Asked Questions on Mandated Coverage for Autism Services and Adjusted Coverage Amount for Intensive and Nonintensive Services
  Updated by the Office of the Commissioner of Insurance (OCI) on 01/05/2012
• Do you need to be Certified yet as an Autism Qualified Provider?
  Please download, fill out and return the WPS Professional Staff Update Notification form.
• Has the service level for your patient been determined?(Intensive vs. Non-intensive). Please download, fill out and return the Autism Spectrum Progress Report form.
• Do you need to review a sample claim form for billing: Testing & Screening; Intensive Services; Non-intensive Services?
  Review the sample claim forms:
  • Testing & Screening
  • Intensive Services
  • Non-intensive Services
• If you need further directions for completion of claim form CMS-1500,
  see the CMS-1500 claim form instructions.