Question 90971/90972 vs 9920x

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I am new to behavioral health, and I want to know when the appropriate times are to use these codes. I work on a college campus, so our providers are sometimes the first psychologists and psychiatrists to treat a client (and do the diagnosing). In that instance, the providers (psychiatrists) are billing 90971 and 90972 depending on the service. Is this correct?

Second, should those same codes be billed if the client has already had psychiatric OR psychologic care and comes to us with a diagnosis, but is new to our practice. Example: Client went to therapist in high school in another state, and now comes to us and transfers care for medication management. In this case, would we just bill a new patient E/M, 9920x?

Thanks in advance!


Best answers
Hi there!

Question 1: Your Psychiatrist can choose to bill
- 90792 Encounter for diagnoses and medical treatment (90791 is typically LCSW etc) - Cannot bill any other psych service for the day
- 9920X & 90833 if they provided both medical and psychotherapy (new or est)
- 9920X or 9921X if there is a psychotherapy done/scheduled on the same day with a different provider

Forgot to mention.. 90791 & 90792 can be billed more than once if during the course of the session, a new condition is diagnosed and treated separate from the first orig diagnosed condition.

Question 2
Correct - if patient comes from a different non affiliated clinic, they become a New patient to you.

Hope this helps.