How to bill 90837 and 90847 together?
Asked by: Dr. Danyka Powlowski III | Last update: April 27, 2025Score: 4.8/5 (75 votes)
Does 90847 need a modifier?
To provide more detailed information about the therapy services offered under 90847, you can utilize specific billing modifiers. These modifiers can provide valuable context that helps better document the services and ensure accurate billing.
Can you bill two therapy sessions on the same day?
Use Modifier 59
Same day modifier “59” describes services rendered for a different session or procedure on the same day. Often times this refers to different surgeries, body parts, or physical treatments. In the context of mental health, however, it simply describes a different session of treatment and nothing more.
Does CPT code 90837 require a modifier?
So, you would use the CPT Code 90837 Modifier 95 for virtual sessions that are 53 minutes or longer. To further maximize your reimbursement, include the appropriate extender code if the session exceeds 53 minutes.
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.
Family and Couple Therapy Billing Guide (CPT Code 90847 & 90846)
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 you use modifier 22 on multiple procedures?
Modifier -22 can only be used on one procedure code, per member, per date of service. D. In order to be considered for additional reimbursement, modifier -22 may only be reported with a valid procedure code that has a global period of 0, 10, or 90 days on the Medicare Physician Fee Schedule (MPFS).
Can you get 90837 and 90847 the same day?
Can you get 90837 and 90847 the same day? You can bill 90837 (individual therapy) and 90847 on the same day if, and only if, the services were separate and distinct.
What is the difference between CPT 90837 and 90847?
The primary difference between 90847 and 90837 is regarding “who” is there for the therapy. CPT 90847 denotes “plural” family members [1]. You can think of it as psychotherapy with “all” the family members, plus the patient. With CPT 90837, the therapy is provided to the patient, and/or one (singular) family member.
What is the 59 modifier for therapy?
If a therapist bills a Current Procedural Terminology (CPT) code linked to one of these pairs, they are generally reimbursed for only one of the codes. In such scenarios, the modifier 59 can be employed to indicate that both services were provided independently, warranting separate payment.
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.
How to justify 90837?
To bill 90837, you must have clear documentation showing the medical necessity for the extra time. Be sure to document things like: The start and end times of the actual session. The issues, topics, and goals addressed and discussed during the session.
When to use modifier 95?
-95: Synchronous telemedicine service rendered via a real-time interactive audio and video communications system.
Why is 90847 less than 90837?
90847 involves family group therapy whereas 90837 is an individual session. The time frame is also different. 90837 sessions must be at least 53 minutes, and 90847 must be at least 26 minutes.
What documentation is required for 90847?
What are the documentation requirements for billing CPT Code 90847? To bill for CPT Code 90847, therapists must document the therapy session's details, including who was present, what was discussed, the date and time of the session, the therapist's credentials, and the patient's diagnosis code.
Can 90837 be billed as telehealth?
The psychotherapy services that CPT designates as appropriate for telemedicine are: 90832 psychotherapy, 30 minutes with patient. 90834 psychotherapy, 45 minutes with patient. 90837 psychotherapy, 60 minutes with patient.
What is the CPT code for a 2 hour psychotherapy session?
This is a super short guide on billing a typical 2 hour individual therapy session for outpatient mental health therapy. You'll want to use your typical 90837 CPT code.
What is the reimbursement rate for 90837?
Therapists use this code when providing extended therapy services to their patients. Just like CPT Code 90834, the reimbursement rate for CPT Code 90837 may vary depending on the payer, location, like in New York the reimbursement rate for CPT code 90837 is $144.83.
Can 90837 and 90839 be billed together?
Because 90839 and 90840 are used for crises, you can't bill these codes in conjunction with the following standard therapy codes: 90791 and 90792 (initial evaluations) 90832, 90834, and 90837 (psychotherapy)
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 modifier for telehealth for psychotherapy?
In behavioral health, the modifier 95 is added to the original code to signify teletherapy. For example, you would add the 95 modifier to 90834 to signify a 45-minute teletherapy session (i.e., 90834-95). To be billed with this modifier, a face-to-face video session needs to have occurred.
How to bill for multiple procedures?
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.
What is an example of a 22 modifier?
Examples include surgery complicated by extensive scarring and adhesions throughout the operative field or surgical access markedly impeded in a morbidly obese patient. Increased procedural services are submitted by appending modifier -22 to the claim form with the primary procedure code.
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.