Home

  • Services
  • Menu
  • Specialties

    • Contact

    Substance Abuse RCM

    Substance Abuse 
    Billing Services

    From residential stabilization to outpatient recovery, Revix MD provides specialized substance abuse medical billing services purpose-built for the current SUD regulatory environment. We synchronize your clinical documentation with payer specific medical necessity criteria to eliminate revenue volatility.

    Revix MD Google Reviews ratingRevix MD Trustpilot verified reviews
    Compliance Expertise

    Navigating the Regulatory Landscape: Parity and Privacy

    Substance abuse and Substance Use Disorder (SUD) billing require a sophisticated defense against aggressive payer compression. Facilities often lose 15–25% of expected revenue to preventable denial prevention services and unmanaged “Step-Down” transitions. Revix MD acts as your advocate, ensuring your facility is compensated for the life-saving care you provide.

    MHPAEA Final Rule Advocacy

    We leverage the MHPAEA Final Rules (September 2024), which mandate that payers treat SUD benefits equitably with medical/surgical benefits. For facilities treating co-occurring psychiatric and addiction disorders, our team manages both billing tracks under a unified parity strategy.

    ASAM-Driven Denial Defense

    We utilize a clinical-first approach, anchoring our concurrent reviews and appeals in ASAM Level of Care documentation. By speaking the language of medical necessity, we legally challenge rejections and secure the authorized days your patients require.

    42 CFR Part 2 Modernization

    We implement the latest federal privacy standards, allowing for seamless data flow between clinical and billing teams. Our systems ensure that 2026 single-consent requirements for SUD record sharing are tracked and audit-ready, preventing administrative stalls in the revenue cycle management services.

    Toxicology and Revenue Code Compliance

    We implement strict “Order-to-Claim” reconciliation for lab billing. Our team manages the technical nuance of facility billing, ensuring correct Revenue Code mapping (e.g., 1002 for Detox, 1003 for Residential, 0905 for IOP) to prevent “Level of Care” mismatches.

    Specialized Services

    Comprehensive Addiction and Outpatient
    Revenue Solutions

    Revix MD manages the high-acuity needs of the full addiction treatment and substance abuse continuum, from acute stabilization to long-term outpatient maintenance.

    medical-detox-and-residential-stabilization-h0008-h0014

    IOP and PHP Continuum Management (H0015, S9480)

    We provide precise coding for sub-acute and acute detoxification, which is why medical coding services are critical for this specialty. Our experts manage the transition from Medically Monitored (Level 3.7) to Clinically Managed (Level 3.5) care, ensuring your UB-04 facility claims are technically perfect.

    iop-and-php-continuum-management-h0015-s9480

    Medical Detox and Residential Stabilization (H0008–H0014)

    The outpatient continuum Partial Hospitalization (PHP) and Intensive Outpatient (IOP) is where long-term practice sustainability is built. We manage the “Step-Down” authorization process 48 hours before transfer to ensure there are no gaps in billable days.

    medication-assisted-treatment-mat-and-telehealth-mastery

    Medication-Assisted Treatment (MAT) and Telehealth Mastery

    We specialize in the complex fee schedules for MAT, including Methadone (H0020) and buprenorphine. We manage current DEA telehealth flexibilities for remote MAT prescribing, utilizing the correct modifiers to ensure compliance while expanding your patient reach.

    high-velocity-vob-and-single-case-agreements-sca

    High-Velocity VOB and Single Case Agreements (SCA)

    Admission windows close in minutes. Our dedicated VOB and eligibility verification pod provides a full breakdown of benefits within two hours. For Out-of-Network (OON) patients, we aggressively negotiate Single Case Agreements (SCA) to secure predictable per-diem rates before the patient arrives.

    Fast Onboarding

    Easy 15-Day Facility Implementation

    Compliance and Coding Audit

    We perform a 90-day retrospective audit to identify documentation gaps and revenue leaks within seven days.

    Secure Platform Expertise

    We securely integrate with your Kipu, Sunwave, or ZenCharts platform through encrypted connections.

    UR and Payer Alignment

    We align your Utilization Review strategy with MHPAEA Parity rules and 1115 SUD Waiver requirements for state-specific Medicaid compliance.

    AR Acceleration

    Go live on Day 15 with 48-hour claim submissions and real time dashboard visibility into your occupancy to revenue ratio and net collections.

    Revenue Improvement

    Turn Complex SUD Billing Into a More Predictable Revenue Process

    Request Your Free Facility Revenue Audit

    Frequently Asked Questions

    We utilize encrypted “Redaction Protocols” during the appeals process. This allows us to provide the clinical evidence required to win an appeal while remaining in total compliance with federal SUD privacy restrictions.

    We operate on a transparent percentage-of-collections model. This ensures our success is tied directly to yours; we only succeed when you collect your earned revenue.

    Yes. Revix MD manages multi-state Medicaid and commercial billing, including the idiosyncratic authorization and room-and-board carve-out rules for state-specific 1115 SUD Waivers.

    Absolutely. We manage the entire lifecycle of facility enrollment and contract negotiation, helping you expand into new states or add new levels of care to your existing payer agreements.

    We manage the “Good Faith Estimate” (GFE) process and ensure all billing for non-contracted patients meets the transparency requirements of the No Surprises Act, protecting you from financial penalties.