Wiki BILLING FOR 90+ MINUTE SESSIONS, EMDR

[michele.como]

Prior to January 2023 my provider would bill Medicare for 90+ minute sessions with code 90837 and 99354. As of January 2023 99354 was deleted and the codes that replaced it 99417 cannot be used with psychotherapy codes. For other insurances that she could not bill the 99354 code she would bill the 90837 and charge the patient a private pay session for the additional time but since the 90837 code is 53 minutes plus I was not sure if the provider could continue to do this and charge the patient for the additional private session if she was in network with the insurance? If not do you have any suggestions as to how the provider can bill for the extended 90 minute sessions?

 

[CBLENNIE]

Sadly, it appears that when the AMA deleted 99354 & 99355 effective 01/01/23 they left providers of psychotherapy services no way for billing extended sessions.

I found the following article was very informative on the topic and author appears to be actively advocating on behalf of providers who perform these services. Prolonged Service Codes.