Wiki 99205

[laurafw02]

Hello,

Has anyone used 99205 in their Psychiatrist office?

I have not been able to locate the code in my CPT book.

What are the requirements to use the code?

Will it make more money than using 90792?

I would really appreciate the help, thank you.

Kind regards,
Laura Wilson

 

[TThivierge]

Hi Laura Wilson
CPT 99205 cannot be used with CPT 90792 or 90791 or crisis CPT codes per CPT manual. Psych docs should use CPT 90792 -90791 first time with mental health dx codes. There are differences in medical problems vs mental health dx . problems in linking the CPT 90791, 90832 Etc vs Eval Mgmnt codes 99201-99215. Most psychiatrist use the CPT code be 90792 or 90791 for first time visit for behav. health problems for new patients. Per the CPT manual you cannot bill these 2 CPT (90792 -90791) with Eval Mgmt codes. The Psychiatry section code in CPT manual pages start pages 647 -648. Also, most payers will let you bill this 90791 once a year for each new mental health problem. But check with the payer.
Checking the CPT linked with a fee would involve checking the CMS website plus it depends on what the payer will pay according to psychiatrist vs LCSW or LPC provider.
I hope I helped you
Lady T

 

[spalac4@wgu.edu]

Hi Laura Wilson
CPT 99205 cannot be used with CPT 90792 or 90791 or crisis CPT codes per CPT manual. Psych docs should use CPT 90792 -90791 first time with mental health dx codes. There are differences in medical problems vs mental health dx . problems in linking the CPT 90791, 90832 Etc vs Eval Mgmnt codes 99201-99215. Most psychiatrist use the CPT code be 90792 or 90791 for first time visit for behav. health problems for new patients. Per the CPT manual you cannot bill these 2 CPT (90792 -90791) with Eval Mgmt codes. The Psychiatry section code in CPT manual pages start pages 647 -648. Also, most payers will let you bill this 90791 once a year for each new mental health problem. But check with the payer.
Checking the CPT linked with a fee would involve checking the CMS website plus it depends on what the payer will pay according to psychiatrist vs LCSW or LPC provider.
I hope I helped you
Lady T

Hello Laura,

I have 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?