Wiki Codes for Psychotherapy

[MalissaMejia]

We have a clinical social worker that would like to start billing for her services. She would like to use codes 90846, 90847, 90849, and 90853. I cannot find anything though that tells me what documenation is required, if they are billed in units, and then if a social worker is even permitted to bill these codes. Most of these will go to Medicare for payment, which looks like the reimbursement is great but I just want to make sure that we are documenting and coding correctly. Any help/guidance is appreciated. Thanks!

 

[masequap]

Psychotherapy Codes

I would start by finding out if your state has a LCD. You can find LCD information by going to http://www.cms.gov/medicare-coverage-database/overview-and-quick-search.aspx . Here in CT, we have two LCD's: L26398 R2 Psychiatric Partial Hospitalization Programs and L26895 R6 Outpatient Psychiatry and Psychology Services. The LCD lists who can perform the service, who can bill for the services, and what documentation is needed to support the services billed, along with other helpful information. In CT, Medicare does cover services performed by a clinical social worker which are paid on the different fee schedule than the physicians. I would also look into using the AJ-modifier for professional billing. I hope this information helps you on your journey.