What is the Intent of CPT 90837
This year's revision of psychotherapy codes has created confusion. I have a therapist who has a treatment plan for family therapy for my member. The member's benefit does not cover group therapy. Provider originally billed and was paid under CPT 90847 Family Therapy. System configuration was corrected to deny 90847 so the provider changed to billing and being paid for CPT 90837 'Psychotherapy with patient AND/OR family member'. I believe the new code is meant for occasional family participation in an individual's treatment and NOT family therapy. Is the provider commiting fraud by billing this way?
This year's revision of psychotherapy codes has created confusion. I have a therapist who has a treatment plan for family therapy for my member. The member's benefit does not cover group therapy. Provider originally billed and was paid under CPT 90847 Family Therapy. System configuration was corrected to deny 90847 so the provider changed to billing and being paid for CPT 90837 'Psychotherapy with patient AND/OR family member'. I believe the new code is meant for occasional family participation in an individual's treatment and NOT family therapy. Is the provider commiting fraud by billing this way?
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