Can you bill 90837 and 90791 together?
Asked by: Brant Weber | Last update: April 10, 2025Score: 4.9/5 (23 votes)
Can you bill 90791 with 90837?
CPT Code 90791 is typically billed for the initial intake appointment a client will have. Subsequent sessions will be billed with procedure codes 90834 and 90837, depending on the appointment duration.
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. What are the time limits for 90847? The session must last a minimum of 26 minutes to be able to bill for this code.
What is the billing guideline for 90791?
How often can CPT code 90791 be billed for one client? Most payers will reimburse 90791 once every 6 months, per client. Code 90791 cannot be reported on the same day as an evaluation and management service for the same patient, or on the same day as psychotherapy services (including for crisis).
Can 90791 and 99354 be billed together?
You can also use CPT Code 90791 with Code + 99354 Add-on if the session is between 90 and 120 minutes. Add-On CPT Code +99355 for an additional 45 minutes of time in the session. Use 90791 + 99354 + 99355 for long sessions of greater than 120 minutes.
Cracking the Code:Understanding CPT 90791
What is the add-on code for 90837?
So are you out of luck and stuck with just billing 90837? Add-on CPT Code 99354 is defined as a prolonged services code and is defined as an extra 30-74 minutes of therapy. 99354 used to only be allowed by Medical Doctor's, but has since expanded and is applicable to 90837 and 90487.
Can you bill for two CPT codes at the same time?
There is a myth that exists that you can't bill 2 CPT codes during the same 15-minute time period. Well, that myth is only partially true. It is possible to bill 2 CPT codes during the same 15-minute time period.
Can 90791 be billed telehealth?
These codes are approved for mental health telehealth billing by both the current procedural terminology (CPT) and the Centers for Medicare Services (CMS): 99201 – 99215 – Evaluation and Management Service Codes. 90791 & 90792 – Diagnostic Interview. 90832 – Psychotherapy for 30 Minutes.
How many minutes is 90837?
Code 90837 is for 60-minute therapy sessions, defined as 53 minutes or longer. Anything less than 53 minutes would use code 90834 (45-minute session). For 90837, the actual session time must be documented in your notes. Rounding up or down is not allowed.
Is a psychiatric diagnostic evaluation with medical services reported with code 90791?
There are two codes for psychiatric diagnostic evaluation. 90791 is used by psychologists, social workers and other licensed behavioral health professional and 90792 is used by psychiatrists and psychiatric nurse practitioners and physician assistants, because it includes medical services.
How to bill 90837 and 99354?
Let's say you had a 120-minute therapy session. The right way to bill this is to submit a claim for 90837 for the first hour then include the add-on CPT code, 99354 for the remaining time. However, if you only met with your client for 80 minutes, then you can only use 90837 to bill for the session.
Can you do two types of therapy at the same time?
Some people want to try different therapy modalities. For example, one of the most common treatments for anxiety and depression is cognitive behavioral therapy, but someone might want to participate in cognitive behavioral therapy, individual psychotherapy, and acceptance and commitment therapy at the same time.
Is 99354 still valid?
Deleted codes: Prolonged services codes 99354, 99355, 99356, and 99357 are no longer in use. In place of codes 99354 and 99355, use 99417. Code 99417 can be used to report prolonged services along with: 99245 (Office or other outpatient consultation for a new or established patient …)
Can I bill 90791 twice?
We strongly recommend against billing multiple intake sessions using CPT code 90791. This is because, most often, this CPT code would be inaccurate after the first session, constituting possible insurance fraud, but most likely a denial of the claim.
When to use modifier 95?
-95: Synchronous telemedicine service rendered via a real-time interactive audio and video communications system.
Can 90791 be billed incident to?
Incident to is not allowed for 90791 and 90792. These assessment services only may be billed by a MD, CNS, NP, CP, CSW, or PA. services, including licensure, imposed by the State in which the services are being furnished.
Why do therapists do 50 minute sessions?
The rationale behind the “50-minute hour” is that it provides the right amount of time to do the therapeutic work. At the same time, it leaves time for the therapist and client to wind down at the end. It also gives the therapist enough time to take a quick break and write notes in between clients.
What are the billing guidelines for CPT 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.
How long is a 90791 session?
If you're using a third-party payor for your services, such as Medicaid, Medicaid states that the 90791 CPT code should be used for at least 16 minutes and no longer than 90 minutes. It may be helpful to use an electronic health records system, as many of them track your sessions' start and end times for you.
How much to charge for 90791?
Typical Reimbursement Rates for 90791
2023: $174.86. 2022: $195.46. 2021: $180.75. 2020: $145.44.
Can therapists bill for phone calls?
Typically, therapists will charge for phone calls with the client if the conversation exceeds a certain amount of time. Calls to family members: Sometimes therapists need additional information from family members, especially if the client is a child.
What is the 95 modifier for behavioral health?
Mental health modifier 95, designated as “synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system,” serves as a flag to insurance carriers, indicating that a mental health service was provided remotely using real-time audio and video technology.
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.
What is the 77 modifier in medical billing?
CPT Modifier 77 'Repeat procedure by another physician': A physician may need to indicate that he or she repeated a service performed by another physician on the same day.
Can you bill a telehealth and office visit on the same day?
E-visits should not be billed on the same day the physician reports an office visit E/M service (CPT codes 99202-99205 and 99211-99215) for the same patient. Additionally, e-visits should not be billed when using the following codes for the same communication: 99091.