Wiki 90791/90792 vs E&M

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Can an ARNP bill 90791/90792 for an admission exam or can they bill these codes at all, if they are not an MD or have a degree is psych, should they then just bill the E&M?

The ARNP is not testing for GAD 4 or PHQ 9 etc. and sometimes the patient has a hx. which would then make this not be diagnostic at all.

I am understanding that only the following can bill these two codes:
  • Licensed Clinical Social Workers (LCSW)
  • Licensed Professional Counselors (LPC)
  • Licensed Mental Counselors (LMHC)
  • Licensed Marriage Family Therapists (LMFT)
  • Clinical Psychologists (PhD or PsyD)
  • Psychiatrists (MD)
Doesn't mention ARNP. So my thinking is they can only bill the E&M (99202-99204) for new pt (99212-99214) established or what codes should the ARNP be using for a psych eval.

Can someone help me understand this better?
 
90791 is for an assessment without medical services so your social workers, counselors and psychologists would use this code.

90792 is an assessment with medical services so anyone that is a medical health care professional can bill that code.

If you think about it this way, 791 is used for ones that can't prescribe and 792 is used for ones who can.

I work in a behavioral health office and the ANRPs use the code 90792 for new patients all the time. 90791 is used for the LCSWs for their new patients.
 
kdsrodriguez said:
90791 is for an assessment without medical services so your social workers, counselors and psychologists would use this code.

90792 is an assessment with medical services so anyone that is a medical health care professional can bill that code.

If you think about it this way, 791 is used for ones that can't prescribe and 792 is used for ones who can.

I work in a behavioral health office and the ANRPs use the code 90792 for new patients all the time. 90791 is used for the LCSWs for their new patients.
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Hello,

Could you help me with a question. I understand that 90791 cannot be billed in conjunction with an e/m by the same individual. Does that mean all the providers in the same office? or just an individual? We have an LCDC billing 90791 and the MD is billing an E/M on the same date of service. Is this allow?
 
There are two codes for psychiatric diagnostic evaluation.

90791 Psychiatric diagnostic evaluation
90792 Psychiatric diagnostic evaluation with medical services

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.

 
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