Psychiatry Coding & Reimbursement Alert
Extremely Long Psychotherapy Sessions - Here's What You Need to Do
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Question: Our psychiatrist has been conducting sessions that last more than one hour. Since time covered for 90837 is 60 minutes, can I bill any other code to cover the extra length of time that my psychiatrist has been spending with these patients in conducting psychotherapy sessions?
Answer: Typically, a psychotherapy session lasts for 45 minutes to an hour. If your psychiatrist is providing psychotherapy and the session lasts for 60 minutes, you will report 90837 (Psychotherapy, 60 minutes with patient and/or family member) for the service. As you have pointed out, there is no specific code to report a session that lasts longer than 60 minutes.
If your psychiatrist conducts a session that is longer than one hour, you will continue to report just one unit of 90837 to describe the service that your psychiatrist provided. You cannot report any other psychotherapy code to compensate for the extra length of time that your psychiatrist provided.
For example, if your psychiatrist provided a therapy session that lasted for one hour and 16 minutes. You will only report 90837 to report this service. You cannot count the extra 16 minutes as being the halfway mark for reporting a unit of 90832 (Psychotherapy, 30 minutes with patient and/or family member) and report one unit of 90837 and one unit of 90832.
But, if the session lasted for a period longer than 90 minutes of face-to-face time with the patient, you can consider adding an appropriate prolonged service code (99354-99357) to cover for the extra time spent on the patient. The appropriate prolonged service code is determined depending on the time spent with the patient and the place of service. These add-on codes should be used in addition to reporting 90837 and time calculated for these codes should be counted beyond the first hour that is spent (reported with 90837).
Reminder: Since 30 minutes is the halfway mark for reporting prolonged services code, you cannot use a prolonged service code if the psychotherapy session lasted for more than an hour but less than 89 minutes.
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