Wiki E/M for counseling evaluations

Messages
1
Best answers
0
Hi – we need the code for evaluations. We used to use 90805 (20 – 30 minutes) or 90809 (70 – 80) minutes. But, a couple things.
1. Our evaluations are usually a day and a half long. We typically do them for DFS, so Medicaid pays and we use an “H” code for those. If you tally up all the hours, including writing the report and costs of tests, it may come to about 35 hours.
2. We don't involve a psychiatrist, and the only code I could find in the new ones for 2013 are for psychiatric assessment. Ours would be considered psychological assessment.
3. I was given the 2013 code of 96101, at payment of $85.37 per unit. I'm assuming the unit would mean a 50 – 60 minute unit, but I'm not sure.

SO – what we need is:

Is the 96101 the right code for psychological evaluation? And is payment $85.37 per hour? Or is there a different code? I looked at the flow chart we got when they switched CPT codes for 2013, but got nowhere.
 
Top