Wiki E/M vs. 90791/90792

[stosadori@legacytreatment.org]

NJ Medicaid only allows these codes 2 times within 365 days. Would it be possible to to bill 99215 time based in placement of them if needed more than that?

 

[lmchugh]

NJ Medicaid only allows these codes 2 times within 365 days. Would it be possible to to bill 99215 time based in placement of them if needed more than that?

For the 90791 (non prescribers) usually, it's either a 1 and done or they continue on with psychotherapy.
For the 90792 Prescribers usually do the E/M or E/M with psychotherapy after the Initial diagnostic evaluation with Medical services. If you look at the CPT book, these 2 codes are for an assessment or a reassessment if required. If the patient presents with a new problem you should be able to bill again outside of that time period.

 

[mariah@sbhservices.org]

Is there any billing limitation for billing the 90792 and H0031 on the same day for different providers type? We are trying to make it so that members have access to services in the time they need them and attempting to eliminate barriers to care. If we were to schedule two separate dates for such services

Thank you in advance for your assistance,