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Wiki bill psychotherapy codes before assessment?

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Airlanda

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Seattle First Hill Chapter
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The behavioral health providers at our clinic asked me how many times they can bill 90832 psychotherapy before an assessment 90791 is required. They think that they can bill up to 4 sessions before they complete an assessment. I cannot find any coding/billing information to support this idea. Does anyone have any information or resource to point me to?
 
It really depends on your facility and policies. May I ask why they would see the patient for psychotherapy 4 times before doing the full psychiatric diagnostic evaluation? I am curious what the rationale is from the providers prospective performing 4 therapy sessions before the full work up. Are they are in transition from an embedded therapist in a primary care environment waiting to get into an outpatient clinic? CMS states that a plan is not required if only a few brief services will be furnished in regards to psychotherapy and treatment plans. If you would like to discuss further I would be happy to help. You can email me directly at Stephanie.moore@wdhospital.org. I would take a look at your LCD for your MAC and the Medicare Claims Processing Manual as resources. Kind Regards, Steph
 
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