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HCPCS S5145

Foster care, therapeutic, child; per diem

HCPCS S5145 Commercial Payers (Non-Medicare)

Description

Foster care, therapeutic, child; per diem

Common Specialties

Physical Therapy, Pediatrics

Documentation Requirements

  • Document clinical indications and clear medical necessity supporting the encounter or procedure.
  • Ensure complete provider signatures, credentials, date, and specific place of service (POS).
  • Verify documentation strictly supports code specificity to prevent downcoding or claim denials.

Billing & Coding Tips

  • Verify current payer fee schedules, NCCI edits, and Medically Unlikely Edits (MUEs).
  • Append correct modifiers (e.g., 25, 59, 26, TC) where distinct procedural services or components apply.
  • Confirm pre-authorization rules with Medicare, Medicaid, and commercial plans before submission.

Related Codes

S5000 S5001 S5010 S5011 S5012 S5013 S5014 S5035 S5036 S5100 S5101 S5102 S5105 S5108 S5109

Quantum Health Services provides full-cycle revenue cycle management and medical billing services nationwide. This code reference is for educational purposes; always verify official payer policies. CPT© descriptors require proper AMA licensing.