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Billing Family therapy, family members are both beneficiaries

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If a provider sees two siblings together during the same visit for an hour of counseling and both siblings are beneficiaries of the same insurance company, how should the provider bill? Should the provider bill a separate claim for each client with code 90837, or should the provider bill 90837 only once for 1 of the clients?
 
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90837

If there is only one primary patient bill for that one only. Or, bill for the one who the session was focused on primarily on that day. If you tried to split it you would have to call it two 30 minute sessions. BUT, that would be unlikely. The provider has to put the time spent in the note. Unless they divided the time like that it would be fraudulent. Best approach, bill the whole visit for the primary patient and using the amount of time the provider put in the note. Note that you are billing for psychotherapy that implies one patient. Code 90847 is for family therapy. This is my opinion, not checking an LCD.
 

deyoung

Guru
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Location
Glendale, AZ
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Just a thought, if he does 2 visits (2 separate notes), each visit focusing on 1 of the siblings, he may be able to bill 90847 for each on a separate claim.
 
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