Community Health Plan of Washington (CHPW) would like to provide an update about admission (“admit”) dates for outpatient services on a professional claim.
When billing the CMS-1500 form, Box 18 identifies an inpatient stay and indicates the admission, and if applicable, discharge dates associated with the service(s) on the claim.
Providers should not bill for an admit date for outpatient services unless billing with the appropriate inpatient place of service (POS) code.
As an example, for POS 55 (Residential Substance Abuse Treatment Facility) and 56 (Psychiatric Residential Treatment Facility), an admit date is not required and should not be billed, as these two codes are considered outpatient.
If an admit date is billed with POS 55 or 56, the claim may be denied and the provider would need to rebill a corrected claim.
If you have any questions about outpatient services or admit dates, please contact [email protected].
