Wiki 90806 vs. 90807

[abalkevitch]

I recently became aware that patients in our office were being seen for a 90862 (med review) and 90806 (individual psychotherapy) on the same day (not every time, but occasionally) and certain insurances disallow these two services to be billed seperately on the same day. I found 90807 includes both the med review AND the therapy, so I assume we should use it for these instances. My question is, because the 90806 was with a therapist and the 90862 is with a Doctor, when I bill a 90807, who is listed as the rendering? The therapist or the doctor?

 

[jcochran]

I recently became aware that patients in our office were being seen for a 90862 (med review) and 90806 (individual psychotherapy) on the same day (not every time, but occasionally) and certain insurances disallow these two services to be billed seperately on the same day. I found 90807 includes both the med review AND the therapy, so I assume we should use it for these instances. My question is, because the 90806 was with a therapist and the 90862 is with a Doctor, when I bill a 90807, who is listed as the rendering? The therapist or the doctor?

If your MD is performing both the therapy and the Med check, use 90807, if your MD is only performing meds and your therapist is performing therapy, then you bill them septerately. The insurances should not kick them back to you since they are seeing seperate providers. If you are having problems with this, you may need to call the insurance and clairify that the client is seeing 2 different providers.
Hope this helps!
Jess