Supervision Requirements Change for 27 Codes

The Centers for Medicare & Medicaid Services has changed the supervision requirement for 27 hospital outpatient therapeutic services from direct supervision to general supervision. General supervision requires the service to be performed under the overall direction and control of a physician or non-physician practitioner (NPP), but the physician’s or NPP’s personal presence is not required.

The change was recommended by the Hospital Outpatient Payment Panel that advises CMS on appropriate supervision levels for individual hospital outpatient therapeutic services, and is supported by the American Hospital Association (AHA), AHA News reports.

Effective July 1, the following mental health services may be conducted under general supervision in accordance with applicable Medicare regulations and policies:

  • 90804 Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately 20 to 30 minutes face-to-face with the patient
  • 90806 Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately 45 to 50 minutes face-to-face with the patient
  • 90808 Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately 75 to 80 minutes face-to-face with the patient
  • 90810 Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an office or outpatient facility, approximately 20 to 30 minutes face-to-face with the patient
  • 90812 Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an office or outpatient facility, approximately 45 to 50 minutes face-to-face with the patient
  • 90814 Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an office or outpatient facility, approximately 75 to 80 minutes face-to-face with the patient
  • 90816 Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an inpatient hospital, partial hospital or residential care setting, approximately 20 to 30 minutes face-to-face with the patient
  • 90818 Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an inpatient hospital, partial hospital or residential care setting, approximately 45 to 50 minutes face-to-face with the patient
  • 90821 Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an inpatient hospital, partial hospital or residential care setting, approximately 75 to 80 minutes face-to-face with the patient
  • 90823 Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an inpatient hospital, partial hospital or residential care setting, approximately 20 to 30 minutes face-to-face with the patient
  • 90826 Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an inpatient hospital, partial hospital or residential care setting, approximately 45 to 50 minutes face-to-face with the patient
  • 90828 Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an inpatient hospital, partial hospital or residential care setting, approximately 75 to 80 minutes face-to-face with the patient
  • 90846 Family psychotherapy (without the patient present)
  • 90847 Family psychotherapy (conjoint psychotherapy) (with patient present)
  • 90849 Multiple-family group psychotherapy
  • 90853 Group psychotherapy (other than of a multiple-family group)
  • 90857 Interactive group psychotherapy
  • G0177 Training and educational services related to the care and treatment of patient’s disabling mental health problems per session (45 minutes or more)
  • G0410 Group psychotherapy other than of a multiple-family group, in a partial hospitalization setting, approximately 45 to 50 minutes
  • G0411 Interactive group psychotherapy, in a partial hospitalization setting, approximately 45 to 50 minutes

Effective July 1, these services may be conducted under general supervision in accordance with applicable Medicare regulations and policies:

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  • 51701 Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine)
  • 90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)
  • 90472 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)
  • 90473 Immunization administration by intranasal or oral route; 1 vaccine (single or combination vaccine/toxoid)
  • 90474 Immunization administration by intranasal or oral route; each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)
  • 99406 Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes
  • 99407 Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes

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