Can you bill 2 units of 90837?
Asked by: Sim Torphy | Last update: June 14, 2025Score: 4.7/5 (2 votes)
How to bill for a 2 hour psychotherapy session?
You'll want to use your typical 90837 CPT code. Then you'll also want to use the Add On CPT code 99354 which declares an additional 30 to 74 minutes of therapy. So any time you do 90 to 2 hours and 14 minutes of therapy, make sure to use the combination of CPT Codes 90837 and +99354.
What is the CPT code 90837 billing guideline?
Time requirements
For a session to qualify for 90837, you must spend at least 53 minutes of psychotherapy with the client during the 60-minute visit. The time does not include testing, report writing, coordination of care, or breaks. It must be direct, face-to-face psychotherapy.
Can modifier 50 be billed with 2 units?
"Modifier -50 should be used for bilateral procedures. Bilateral procedures should be listed on the claim as a single line item, with modifier -50, and a two in the units field."
How many units can you bill for 97153?
How many units? It's a category 1 code, so it is billed in 15 minute units (1 hour equals 4 units). This is your "supervision" code, but be very careful using that word. Typically, you should be requesting at least 10% of the 97153 code for supervision per week (i.e. 30 hours of 97153 = 3 hours of 97155).
Unpacking Billing for Your Therapy Hour: 90834 vs. 90837
Can you bill 2 units of 97530?
Billing statement creation (CPT Code + Unit): Now, you would enter the 97530 code in the billing statement, then use the units field to indicate the two units provided to the patient.
Can you bill 2 units of 96127?
CMS does not limit the number of times CPT code 96127 may be billed per year. There is an MUE limit of 3 units per date of service. Although major insurances typically follow MUE guidelines, they may impose their own limits on the number of times per year that 96127 may be billed.
Can you bill multiple units of 90853?
It's recommended for billing purposes to have no more than 10 participants in a group if you're billing Medicaid or Medicare. The CPT code 90853 can be billed no more than once per day.
When to use 59 or 51 modifier?
Modifier -51 would be attached because the biopsy is the lesser-valued procedure done at the same session, and modifier -59 would be attached to indicate that the biopsy, which is normally bundled with excision of the same lesion, was done on a separate lesion from the one that was excised.
Can 95886 be billed with 2 units?
Report either code 95885 or 95886 once per extremity. Codes 95885 and 95886 can be reported together up to a combined total of four units of service per patient when all four extremities are tested.
Can I bill 90837 for 50 minutes?
Therapists use CPT code 90837 to bill for psychotherapy sessions lasting 53-60 minutes. It replaced the previous code 90808 in 2013. This code applies to individual psychotherapy sessions that need more time than the standard 45 or 50-minute session (billed under CPT code 90834).
What is the Medicare allowable rate for 90837?
The reimbursement rates for CPT Code 90837 vary depending on the year and insurance provider. As of 2023, the Medicare reimbursement rate for a 60-minute individual therapy session is $147.07. In previous years, the rates were $164.84 (2022), $152.48 (2021), and $141.47 (2020).
How to justify 90837?
- Did the nature of the treatment justify the time length of the session? ...
- Does the nature of the treatment justify the frequency of treatment sessions? ...
- Was the treatment rendered medically necessary?
What are the criteria for billing 90837?
For CPT code 90837 (psychotherapy, 60 minutes with patient), a physician or other qualified health care professional can report a prolonged service code if the psychotherapy service, not performed with an E/M service, is 90 minutes or longer involving direct patient contact.
Can you have 2 hour therapy sessions?
Can a therapy session be 2 hours? Yes, it's possible for therapy sessions to last this long. Individuals in intensive therapy programs, such as Intensive Outpatient Programs (IOP) or Substance Abuse Comprehensive Outpatient Treatment (SACOT) might meet with a therapist for longer periods.
What is the 51 modifier with example?
Modifier 51 Multiple Procedures indicates that multiple procedures were performed at the same session. It applies to: Different procedures performed at the same session. A single procedure performed multiple times at different sites.
How many times can you use modifier 59?
Don't report CPT code 97750 with modifier 59 if you perform 2 procedures during the same time block. You may report modifier 59 when you perform 2 timed procedures in 2 different blocks of time on the same day.
What is the 57 modifier used for?
CPT modifier 57 may be used to report the decision for surgery for certain codes. This modifier may be used to indicate that an evaluation and management (E/M) service performed on the same day or the day before a major surgery (090 global days) by the surgeon resulted in the decision to perform the procedure.
Can you bill two therapy sessions on the same day?
If you truly conducted an individual therapy session with your client, followed by a separate and distinct family or couples therapy session, then you could bill the two codes on the same day.
How many units do you bill with modifier 50?
If the procedure is performed bilaterally, modifier 50 should be appended to the procedure code with 1 unit of service.
Can 64636 be billed with 2 units?
CPT codes 64633, 64634, 64635, 64636 are reported per joint, not per nerve. Although two nerves innervate each facet joint, only one unit per code may be reported for each joint denervated, regardless of the number of nerves treated (AMA CPT Manual 2023).
Can you bill 2 units of 97110?
The Codes. Per the Medicare 8-minute rule, it would be appropriate to bill Medicare in one of these three ways: two units of 97110 (therapeutic exercise), one unit of 97112 (neuromuscular reeducation), and one unit of 97116 (gait training) two units of 97110 and two units of 97116.
What is the 59 modifier used for?
Definitions. Modifier 59 describes a distinct procedural service, and is used to identify procedures and services that are not normally reported together.
Can you bill 2 units 20610?
For example, if the provider performs an aspiration and injection on the left knee and a separate aspiration and injection on the right knee, two units of the 20610 code can be reported, each with the designated modifiers for bilateral procedures.