Service Codes

Information about Service Codes in Billing

Billing / Service Codes How to Download the Service Codes Report

The Service Codes report contains all of the service code information in the  Billing module.

To export the Service Codes report:

  1. Navigate to the  Billing module and select Service Codes
  2. Select any desired filters to filter the screen 
  3. Click the cloud  icon on the right-hand side and select CSV or Text file
  4. Click  Download on the “Export” pop up to download the file to your computer. The file will also be located in the  Files module

Click here to learn more about Service Codes.
Click here to learn more about the Service Codes Grid.

Billing / Service Codes Enforce a Place of Service in a Service Code

Users with the (Authorizations > Manage) permission can enforce a Place of Service within a new authorization. To enforce a Place of Service, first, create a new authorization

In the Service Code(s) tab of the authorization:

  1. Select a Place of Service in the Enforce Place of Service (optional) drop-down
  2. Click Save

When adding a Place of Service to an existing authorization, it will not automatically update in an already scheduled appointment. The appointment validation logic runs when creating a new appointment or modifying an existing appointment. Edit the scheduled appointment or create a new appointment for the place of service to update.

When scheduling an appointment and entering a service code with an enforced Place of Service, the Place of Service cannot be edited from the Scheduling screen. However, users with the (Appointments > Override Authorizations) permission can bypass Place of Service requirements and select a different Place of Service.

Click here to learn how to schedule an appointment.
Click here for Scheduling module permissions.

Billing / Service Codes Set Employee Credential Requirements in Service Codes

Organizations can restrict scheduling based on employees’ credentials, through fee schedules. To utilize this feature, employee certifications must be added to their profiles. Click here to learn how to add certifications to employee profiles.

To set scheduling restrictions based on employees’ credentials:

  1. Navigate to the  Billing module and select Service Codes
  2. Click on Fee Schedule Rates at the top of the grid and check the service codes within the fee schedules grid to add restrictions to
    • Click View/Update under the “Certification” column if restrictions have already been set
  3. Click the Actions drop-down and select Update credential restrictions to create credential groups or edit existing ones
    • Please note, when selecting more than one service code, if one code already has credential restrictions, the old restrictions will be overwritten with the new restrictions being set.
  4. Fill in the Required Credentials Group with the provider’s required credentials

    • Within a credential group, all credentials are required for the provider to perform a service. Multiple groups can be created to customize credential requirements.
    • When using multiple groups, at least one group must match provider credentials in order for the service to be performed.
      • For example, BCBAs would be in a separate group from RBTs (as seen in the above image), but both can perform the service.
        • i.e. The first group must be RBT and have HIPAA training, and the second group must be a BCBA and have HIPAA training.
    • Select Add Credentials Group to add more credentials

5. Click Update

When scheduling an appointment, users with the (Appointments > Override Required Credentials) permission can bypass credential warnings for providers without the correct credentials.

Click here for Scheduling module permissions.

Billing / Service Codes How to Remove Employee/Client Rates from a Service Code

To remove employee/client rates from a service code:

  1. Navigate to the Billing module and select Service Codes
  2. Choose a code you want to remove the custom rate from and select the number under the Rates column to open all of the custom rates linked to that code
  3. After opening the rates, find the contact you want to remove from the service code and click the gear icon under the Options column
  4. Select Delete Custom Rate

This cannot be done in bulk, but, for more than one service code:

  1. Navigate to the Billing module and select Service Codes
  2. Click Custom Rates and filter for the contact
  3. Delete the rate and all necessary service codes

Billing / Service Codes Checking if a Service Code is Active or Deleted

To schedule an appointment with multiple participants, the employees first need to be connected to one another, and then given the permission to view and manage each other’s schedules. After employees are connected with the correct permissions, they can schedule an appointment and add a service code. Service codes must be active to be added to an appointment.

How to check if a service code is active or deleted:

  1. Navigate to the  Billing module and click Service Codes
  2. The Service Codes grid automatically filters by Active Service Codes

3. You can search for a specific code in the search bar, or click the Active Service Codes drop-down and select Deleted Service Codes

  • If a code is deleted, click the icon on the right-hand side, under Options to undelete it

Billing / Service Codes Create, Edit, and Assign Service Codes Labels

Assigning labels to Service Codes allows you to organize your codes to easily sort, filter, and search for them.

To create or edit a new Service Code label:

  1. Navigate to the  Billing module and select Service Codes
  2. Click the funnel icon on the top left corner to expand the left-hand side panel
  3. On the Labels tab, click the gear icon next to Organization Labels
  4. Complete the Labels form:
    • Choose Label: click the drop-down and select Add New Label to create a new label, or select the name of the label you want to edit
    • Name: enter or edit the label name
    • Parent: click to select or edit the parent label, if any
    • Click to select the background and text color for the label
    • Click Create Label
    • Click the x on the top right corner to close up the Labels form

To assign or remove labels to Service Codes:

  1. Navigate to the  Billing module and select Service Codes
  2. Under the Labels column, click the label  button of the Service Code you want to add or remove labels from/to
    • Enter the name of the label you want to add to the Service Code
    • Click the x next to a label you want to remove from the Service Code
  3. Or, to label multiple codes at once, click the checkbox  on the left-hand side of the Service Codes you want to label
    • Click Actions  on top of the Service Codes grid and select Label Selected
    • Click the field under Apply Labels and select the label you want to apply to all of the Service Codes. Add as many labels as needed
    • Click the field under Remove Labels and select the label you want to apply to all of the Service Codes. Add as many labels as needed
    • Click Apply Label Changes

Billing / Service Codes Create a Service Code

To create a new service code:

  1. Navigate to the  Billing module and select Service Codes
  2. Click the  Add New button at the top right-hand side of the page
  3. Complete the Basics form:
    • Type: defines the type of code. Select one:
      • Unknown
      • Billable
      • Non-billable
    • Code: enter the code value, which will be the code sent on the claim
    • Description: enter the organization’s internal description of the code. This value is not sent on the claim and serves as an internal reference to easily know what the code is
    • Enforce Rate: first level of security to limit user access to the code. Select one:
      • Default rate can be used: every client and provider will be linked to the code and the billing rate will be the default entered
      • Enforce custom provider rate: employees can submit timesheets with their custom rate for the code for any client within their network. If a client is not listed with a custom rate, it will charge the default rate
      • Enforce custom client rate: the code can only be used for specific clients. Clients will be billed their custom code rate when the code is used by any provider in their network
      • Enforce custom provider & client rate: the code can be used by specific providers for specific clients. Clients will be billed at their custom rate and providers can only charge their custom rate
    • Calculation type: tells the system how the code will work for billing and payroll purposes. Select one:
      • Bill by time/Pay by time: calculates the billed amount and the employee’s pay, based on the amount of time on the timesheet. Does not round
      • Bill by units/Pay by time: calculates the billed amount based on the number of units and the employee’s pay, based on the amount of time on the timesheet
      • Bill by units/Pay by units: calculates the billed amount and the employee’s pay, based on the number of units on the timesheet
    • Default Units: enter the number where the system must start counting, when the code is used (E.g. 1, 15, 30, etc)
    • Default Service Location: select the service location starting point
    • Minutes per Unit: enter how the system should count from 1 unit to 2 units, from 2 to 3, etc. If you have a flat-rate code, leave blank, and the system will default to 1. Select how to round up:
      • Round at halfway (default): defaults to rounding halfway
      • Rounds past halfway (half + 1)
    • Default Minutes: enter how many default minutes should the code fill in an appointment
    • Modifiers: enter suggested modifier groups for timesheet conversion, if any
    • Validation: complete this section to define the items that need to be completed on the timesheet whenever the code is used. For each validation, select: (1) Not needed if it should not be included in the timesheet, (2) Optional if it should appear, but would be an optional field to complete, or (3) Required if it is a required field to be completed
      • Service Location: point of service physical location
      • Service Address: point of service address
      • Procedure Info: details about the procedure
      • Drive Time & Miles: total drive time and miles
      • Service Notes: 140 characters required to be filled out pertaining to service notes
      • Admin Notes: 140 characters required to be filled out pertaining to admin notes
      • Provider Signature: if the provider signature is required
      • Client Signature: if the client signature is required
      • Client Signature Form: if  the client signature form is required
    • Restrictions: complete this section to set up additional code configuration
      • Required authorization: will determine if the code must have an authorization before it can be used. If required, the code will not be available, unless there is an authorization available for the client, and nobody will be able to convert the code without an authorization. Select one:
        • Required
        • Optional
      • Enforce Single Timesheet Conversion: check for the code to only be converted once from the schedule. The restriction is bypassed by the organization account, or users with the permission (Manage > Timesheet Conversion), who will be able to convert more than once, if the permission is enabled
      • Requires Schedule Conversion: check to enforce the code to only be used and converted from a schedule. The restriction is bypassed by the organization account, or users with the permission (Manage > Timesheet Conversion), who will be able to convert outside of the schedule
        • If checked, the code will not be available to be used when adding a timesheet manually from the + Add New Timesheet section in the  Billing module
      • Restrict Early Timesheet Conversion: check to restrict appointments with the code from being converted before the appointment actual start time. If enabled, no user can bypass this restriction
      • Lock Grace Period: enter to define how many days after the appointment date, the appointment must be converted before needing admin help. The restriction is bypassed by the organization account or users with the permission (Manage > Timesheet Conversion), who will be able to convert passed the grace period
    • Misc
      • Show client rates: check for clients to view the rates of the service codes in their CentralReach account
  4. Click the Note Templates tab to set up the templates providers need to attach to the service code:
    1. Click the icon to add a new template
    2. Enter the template name in the new field that appears
    3. Click the drop-down to select whether you want the note to be Optional or Required
    4. Click Save

Once the code is created, it must have a fee schedule assigned for the code to be used. Click here to learn how to assign a fee schedule.

Billing / Service Codes How to Delete a Service Code

To delete a service code:

  1. Navigate to  Billing module and select Service Codes
  2. Click the service code you want to delete
  3. Scroll down to the bottom of the page and click Delete
  4. Click Yes to delete this billing code
  5. Deleting a service code moves it to Deleted Service Codes. Deleted service codes can be restore at any time

Click here to learn how to restore a deleted service code.

Billing / Service Codes How to Recover a Deleted Service Code

To recover deleted service codes:

  1. Navigate to  Billing module and select Service Codes
  2. Click on the Active Service Codes  option on the top of the grid and select Deleted Service Codes
  3. To recover one service code:
    • Click the restore button under the Options column on the right-hand side of the code
  4. To recover multiple service codes:
    • Click the checkbox  next to each code you want to restore
    • Click the Actions  option on the top of the page and select Undelete selected
  5. Click Yes in the Confirm pop-up

 

Billing / Service Codes Edit a Service Code

To edit a service code:

  1. Navigate to the  Billing module and select Service Codes
  2. Click the service code you want to edit under the ID column
  3. Edit the code details
  4. Click Save

Billing / Fee Schedules / Billing / Service Codes Add a Fee Schedule and Rate to a Service Code

Service Codes can be assigned to multiple Fee Schedules, based on the agreed payor rates. Service Codes must have at least one fee schedule attached, otherwise, a yellow warning  will be displayed to the left of the code. The default rate associated with the Fee Schedule is the rate an insurance company or private client will be billed for such service.

To assign Fee Schedule and a rate to a Service Code:

  1. Navigate to the Billing module and select Service Codes
  2. Click the gear   icon under the Options column on the right-hand side, and select Add Default Rate
  3. Click the Fee Schedule  drop-down and select the Fee Schedule you are associating to the code
  4. Enter the Rate, which is the amount you are charging for a specific service
  5. Enter the Agreed Rate, which is the rate negotiated with the insurance payor for the service. If you do not have agreed rates you can enter the Rate used above
  6. Click Add

Billing / Service Codes How to Add Custom Employee Rates to Service Codes Via Paycodes

After creating pay codes and assigning them to employees, add multiple provider rates to the service codes in bulk. An employee’s pay rate will be applied as their provider rate for those codes.

  • For example, employee A is assigned to pay code “BCBA” with a rate of $50. Now, if a custom rate is added to service code “H2014,” using employee pay code “BCBA,” employee A will be paid $50 for any timesheets they submit using code “H2014”
    • If employee A is also assigned to pay code “Admin” with a rate of $30, you can apply that pay code to your Admin service codes. This will allow you to pay providers different rates based on the type of work performed

To add custom rates to a service code:

  1. Navigate to the  Billing module and select Service Codes
  2. Click the checkbox next to each code you want to apply provider rates to
    • If a label was assigned to those codes (E.g. “BCBA” or “Admin”), filter by that label and select all, using the checkbox in the column header
  3. Click the Actions  option on the top of the grid and select Add custom rates from paycodes
    • You can only apply rates from paycodes when there is not a provider rate already set up. For codes with an existing provider rate, use the Update rates for selected option
  4. Select Click to add paycodes  and select a paycode
    • Continue to click Click to add paycodes  to add more paycodes to the code
  5. Click Add. All employees with a pay rate for the selected paycodes will now have a provider rate set up for the selected service codes

Notes & Forms / Notes & Forms Templates / Billing / Service Codes Link a Note Template to a Service Code

Clinicians can be prompted to complete a specific Note Template when submitting their timesheet for a specific service code, when the service code is linked to the template in the Billing module.

To link a Note Template to a single service code:

  1. Navigate to the  Billing module and select Service Codes
  2. Click on the service code you want to link to a note template
  3. Click the Note Templates tab
  4. Click the icon on the top right-hand side to add a new template
  5. Enter the template name in the new field that appears
  6. Click the drop-down to select:
    • Optional: if it is not mandatory to fill out the note to submit the timesheet
    • Required: if it is mandatory to fill out the note to submit the timesheet
  7. Click Save

To link a Note Template to one or more service codes in bulk:

  1. Navigate to the  Billing module and select Service Codes
  2. Click the checkbox  on the left-hand side of the service codes to link to a Note Template
  3. Click Actions  on top of the grid and select Add a notes template to selected
  4. Enter the template name
  5. Click the drop-down to select:
    • Optional: if it is not mandatory to fill out the note to submit the timesheet
    • Required: if it is mandatory to fill out the note to submit the timesheet
  6. Click Add

Billing / Service Codes Add Employee or Client Rate to a Service Code Individually

To add or update the provider and/or client rate of one or multiple service codes individually:

  1. Navigate to the Billing module and select Service Codes
  2. Click the checkbox  icon next to the service codes you want to add custom rates to
  3. Click the Actions button on the top of the grid and select Update rates for selected

4. Complete the Bulk update custom rates form:

  • Client: optionally, if you are updating a client rate, enter the client name (not commonly used)
  • Client Rate: optionally, enter the client rate (not commonly used)
  • Employee: if you are updating an employee rate, enter the employee name
  • Employee rate: enter the employee rate
    • Add their hourly rate if the code is set to Pay by time
    • If the employee is salaried, add $0 for Employee rate
  • Click Update rates

5. Once you have added the rates, the code will be available to be used by that particular employee

Click here to learn how to add multiple employees to multiple service codes via paycodes.

Billing / Service Codes How to Edit a Modifier

To edit a service code modifier:

  1. Navigate to the  Billing module and select Service Codes
  2. Click the Fee Schedule Rates option on the top of the grid
  3. Search the fee schedule you want to edit, and update the correspondent modifier information
  4. Click Save Changes on the top of the screen

Billing / Service Codes Add Service Code Modifiers or Group Modifiers

To add a service code modifier to a service code:

  1. Navigate to the   Billing module and select Service Codes
  2. Click on the service code you want to add optional modifiers to
  3. Next to the Modifiers section, add your modifiers
  4. Click Save

To add a new modifier group:

  1. Navigate to the  Billing module and select Service Codes
  2. Click the Fee Schedule Rates option on the top of the grid
  3. Click the Settings  icon to the right of the code under the Options column, and select Add Modifier Group
  4. Complete the Add New Modifier Group form:
    • Name: enter the modifier name
    • Location: select the location from the drop-down
    • Rate: enter the amount you are charging for the service
    • Agreed Rate: enter the rate negotiated with the insurance payor for the service. If you do not have agreed rates, enter the Rate used above
    • Click Add
  5. Once set up, these modifiers will automatically apply to any timesheets using this fee schedule/service code combination

Click here to learn how to edit a modifier.

Billing / Service Codes Update Service Code Rates in Bulk

You can add or update service code rates in bulk for many employees. You might find this useful for your non-billable codes. For example, you may have an administrative service code for meetings, where all employees get paid a rate of $12/hour.

To update service code rates in bulk:

  1. Navigate to the  Billing module and select Service Codes
  2. Click the Custom Rates option on the top of the grid
  3. Enter the service code name on the top search bar to filter the service code
  4. Enter the new rate under the Employee rate column and hover over to the left of the employee rate and click the double arrow icon that appears to set the provider rate for all of the entries filtered
  5. Click Yes in the Confirm pop-up to set up the rate for all the employees for the entries selected

Billing / Service Codes Set Up Unpaid Service Codes

To track unpaid time, you can create unpaid service codes for your organization. This allows you to report on activities, such as lunch breaks.

To create an unpaid service code:

  1. Navigate to the  Billing module and select Service Codes
  2. Click the +ADD NEW button at the top right-hand side of the page
  3. Complete the form with following details:
    • Code: enter the code value
    • Description: enter the organization’s internal description of the code
    • Enforce Rate:
      • Select Default rate can be used if any employee will be able to use the code
      • Select Enforce custom provider rate to restrict the code to only some employees
    • Go to the bottom of the form, Restrictions:
      • Click Requires Authorization and select Optional, since you will not be using an authorization with this code
  4. Click Save
  5. After creating the unpaid code, add a $0 rate for each employee who will use this code

Billing / Service Codes Set the Default Minutes on a Service Code

You can define the amount of time to be added to an appointment for a specific service code. This is done by setting up the Default Minutes field within a service code’s settings.

To edit a service code with default minutes:

  1. Navigate to the  Billing module and select Service Codes
  2. Click on the service code you want to edit
  3. Go to Default Minutes and enter how many minutes this code should fill in an appointment
  4. Click Save
  5. Once the default minutes are set up, any codes that are set up a with a default length will automatically adjust to the default minutes, regardless of the entire appointment length

Billing / Service Codes Set Service Code Rounding Rules

You can set up rounding rules for service codes.

To edit a codes rounding rules:

  1. Navigate to the  Billing module and select Service Codes
  2. Click on the service code you want to edit
  3. To the right of Minutes per Unit click the drop-down and select:
    • Round at halfway (default): This means that once the time gets to exactly half of the Minutes per Unit value, the system will round the unit up. For example, if you have a 30-minute unit and there is an entry that is 15 minutes, then the unit will show as one. If the entry is 14 minutes, then the system will round this down to 0 units
    • Round past halfway (half + 1): This means that the system will round the units up once the entry is half of the Minutes per Unit, plus 1 minute. So in the above scenario, the 15-minute entry would round down to 0. Once the entry gets to 16 minutes, then it would round up to 1 unit
  4. Click Save
    • Please note, all newly created codes will default to Round at halfway (default)

Billing / Service Codes Set a Service Code to Require an Authorization

Some service codes require an authorization before they can be used to bill clients. To always require an authorization for a service code and prevent a service code from being used without an authorization, set up the code to always require an authorization.

To edit a service code to require an authorization:

  1. Navigate to the  Billing module and select Service Codes
  2. Click on the service code you want to edit
  3. Go to the Restrictions section on the bottom of the form
  4. Under the Requires Authorization section, click the drop-down and select Required
  5. Click Save

Billing / Service Codes Provider or Client Signature Requirements

In each service code’s settings, you can choose whether or not to collect a signature for the timesheet to be converted.

To edit a service code signature requirements:

  1. Navigate to the  Billing module and select Service Codes
  2. Click on the service code you want to edit
  3. Scroll down to the Validation section and go to the Provider Signature and Client Signature drop-downs
  4. For each drop-down, select one of the following:
    • Not Needed: timesheets converted using this code will have the signature field removed
    • Optional: timesheets converted using this code will include an optional signature field
    • Required: timesheets converted using this code will include a required signature field
  5. If you set the client signature to optional, another field called Client Signature from will appear. Select whether you want clients to be able to sign only from the provider account, their client account, or either
  6. Click Save

Billing / Service Codes Set Up Grace Period to Service Codes

In each service code, you can define the grace period employees have to submit a timesheet after the appointment ends.

  • For example, if an appointment has a service code with a grace period of 7 days, that employee has 7 days from the date of the appointment to convert to a timesheet. Once the 7 days have passed at UTC midnight, the employee will not be able to convert the appointment unless they have the permission (Billing > Manage Timesheets) enabled

To set a grace period for a service code:

  1. Navigate to the Billing module and select Service Codes
  2. Click on the service code you want to edit
  3. Scroll down to the Restrictions section
  4. Go to Lock Grace Period and enter the number of days of the grace period
  5. Click Save

To convert an appointment past the grace period, the organization’s account or a user with the proper permission rights would have to convert the appointment on behalf of the employee. Or, the service code grace period can be temporarily removed or extended, so the employee can convert the appointment. If so, the grace period would need to be updated back to its original value after the appointment is converted.

Billing / Service Codes Set Up a Flat Rate Service Code

For services that need to be paid at a flat rate, regardless of how much time is taken to complete the service, we recommend setting up your code as “Bill by units, Pay by time.”

To update a code to bill as a flat rate:

  1. Navigate to the  Billing module and select Service Codes
  2. Click on the service code you want to edit
  3. Click the Calculation Type drop-down and select Bill by units / Pay by time
  4. Go to Default Units, and enter the units. Please note, if the payor requires you to bill by a certain unit (E.g. 2 units), then default to the requirements as outlined by your payor

5. Go to Minutes per Unit and ensure it is blank

6. Click Save