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Group psychotherapy in school

J

JenniferV@expressbilling.net

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Chesapeake, VA
My provider wants to start billing group psychotherapy(CPT 90853) with a school as the location. I'm really not familiar with this...Would you just bill it normally and change the place of service to 03 for school? Thanks in advance.
 
JenniferV@expressbilling.net said:
My provider wants to start billing group psychotherapy(CPT 90853) with a school as the location. I'm really not familiar with this...Would you just bill it normally and change the place of service to 03 for school? Thanks in advance.
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I'm not 100% on this as we've never tried to do anything like this before, but from what I've read, it seems to payer specific as to whether or not they will cover services in a location as a school. Is there a specific reason that your provider wants to do this in a school? It'd probably be the case that that question will be asked by most payers. You'd also need signed authorization from each patient indicating they are permitting this activity to happen at that location.

I'm not sure, but I'd bet you'd have to get written authorization from the school stating they are allowing such activity to happen. Also, you may run into issues as far as liability for the school and what not, so maybe seek out the proper person at the school district's office and ask about it. Waivers probably have to get signed and so forth.

Ultimately, I'd put the billing on hold and perhaps ask the provider to hold off on doing it until you can make sure he/she is covered so he/she doesn't end up in hot water. Then I'd check with the payers (each one, ugh, I know), check with the school district and/or the school, and with the patients (or parents). I'd get signed authorizations until your office is full of them. Better to have them even if they aren't necessary than to fly blindly into a situation where you and/or the provider gets a"no-no" letter.

I know that's not a specific answer, but nonetheless, that's my two cents.
 
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