So How Is Everyone Interpreting 90833?

[Bartelby]

For the one therapy code per practice rule does that also apply to something like a University medical center?

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[splik]

Related point. Can a psychiatrist add the 90833 code to a 99213/4 if later in the same day in your practice a therapist bills for psychotherapy?

So it doesn't matter if the therapists in your practice or not. In general, commercial insurance will only cover one unit of individual psychotherapy from anyone on the same day (does not apply to medicare who will pay both). However, if you are providing the service, I would still bill for it. Insurance might cover it, or they most likely will write it off. Or they will write off the therapist's billing.

If you are employed, you should definitely still bill for it. If you get paid on wRVUs, it doesn't matter whether insurance covers it or not, you're supposed to be paid for work done, so bill for it even if it gets written off, you should still receive the wRVUs.

Also the above only applies for individual therapy. For example, if you bill 90833/90836/90838 add on, that might conflict with a therapist billing 90832/90834/90837.

If a pt has a group therapy session 90853 or family therapy session (90846 or 90847) on the same day, there is no issue with 90833 or other add on codes being billed since its a separate service from individual therapy.

 

[J ROD]

If you are employed, you should definitely still bill for it. If you get paid on wRVUs, it doesn't matter whether insurance covers it or not, you're supposed to be paid for work done, so bill for it even if it gets written off, you should still receive the wRVUs.

Point taken.

 

[HomerWells]

Anyone have a good 90833 template? Starting to accept insurance in my practice and plan on billing therapy add on codes. Would like to make my notes audit proof but I've seen mixed info regarding requirements and they seem to vary between carriers. I've seen mention of including total time spent, start/stop times, treatment modality, functional status, MSE, target symptoms, goals, techniques used in visit, treatment plan, prognosis, and progress.

 

[BiscoDisco]

Are you able (and if so how often are you?) to bill a 99205 and a 90833 or 90836? I do 75-90 minute long intakes and I will often get into dynamic concepts or simply engage in supportive therapy to build rapport early on. I am about to start billing insurance and curious if this would be acceptable.

 

[clausewitz2]

Are you able (and if so how often are you?) to bill a 99205 and a 90833 or 90836? I do 75-90 minute long intakes and I will often get into dynamic concepts or simply engage in supportive therapy to build rapport early on. I am about to start billing insurance and curious if this would be acceptable.

Remember you can't bill 99205 on time if you are adding a therapy code, only complexity. That said, I have billed a fee 99205+90833s. These usually involved starting people on lithium who had a lot going on.

 

[splik]

Are you able (and if so how often are you?) to bill a 99205 and a 90833 or 90836? I do 75-90 minute long intakes and I will often get into dynamic concepts or simply engage in supportive therapy to build rapport early on. I am about to start billing insurance and curious if this would be acceptable.

I used to do this all the time before the 2021 E&M changes. nowadays it's very hard to bill 99205 on elements if they aren't sick enough to need hospitalization. If you are rxing lithium or clozapine AND they are acutely decompensated, that would also count. If they have signs of serotonin toxicity or NMS that would count too. But these kinds of scenarios don't come up that often. So it's going to be 99205 + 99417 or 99204+90836 depending on the reason for the visit and what your interventions look like.