Wiki LCSW attending feedback session and receiving payment

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annapadgett

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Hello! Seeking some assistance w/ coding! I have a clinic w/ 30 LCSW's. A PsyD was recently added to the clinic and she will be performing neuropsych testing. The LCSW's w/in the clinic are referring their clients to the PsyD for testing. The PsyD is asking me how to bill for the referring LCSW to attend the feedback session. I am hitting a brick wall here. Is this even billable? She asked that we use the collaborative codes, but I informed her we are not set up for that model and those codes wouldn't apply. Is this even billable? TIA!!!!!
 
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I'm not sure what it means to 'attend a feedback session'. Codes are assigned to specific services that are performed to diagnose and/or treat a patient. So the documentation has to show that some specific service was performed. There's nothing that can be billed simply for attending a session unless the provider actually documented that they performed some kind of service for the patient during that 'attendance'. Hope that makes sense?
 
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thomas7331 said:
I'm not sure what it means to 'attend a feedback session'. Codes are assigned to specific services that are performed to diagnose and/or treat a patient. So the documentation has to show that some specific service was performed. There's nothing that can be billed simply for attending a session unless the provider actually documented that they performed some kind of service for the patient during that 'attendance'. Hope that makes sense
Click to expand...
 
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Thank you for your response! Here is what has been asked to me:

I said the following:

To bill an individual session for the LCSW attending a “results” appointment, is not billable. What would the therapist’s notes include? No therapy is rendered.

We are not set up to provide collaborative care either.

When it comes to choosing CPT codes, the service rendered must match the service provided to a T. We are not “allowed” to pick a code that is the closest definition to a service.

Response:
Hi Anna

I know it might seem that way (regarding the therapist's role) but it is definitely not the case in feedback sessions (especially when the client is referred by the therapist). I attached a de-identified copy of a sample report so you can see the structure. The feedback is very focused to clinical feedback and I usually spend the entire time discussing the results with the client and therapist and exploring how it can be used in therapy. When a therapist is included in the feedback, the session often goes much longer than one where it is just me and the client (or family).

96132 and 96133 are the codes I have included for collaboration with referral
 
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annapadgett said:
Thank you for your response! Here is what has been asked to me:

I said the following:

To bill an individual session for the LCSW attending a “results” appointment, is not billable. What would the therapist’s notes include? No therapy is rendered.

We are not set up to provide collaborative care either.

When it comes to choosing CPT codes, the service rendered must match the service provided to a T. We are not “allowed” to pick a code that is the closest definition to a service.

Response:
Hi Anna

I know it might seem that way (regarding the therapist's role) but it is definitely not the case in feedback sessions (especially when the client is referred by the therapist). I attached a de-identified copy of a sample report so you can see the structure. The feedback is very focused to clinical feedback and I usually spend the entire time discussing the results with the client and therapist and exploring how it can be used in therapy. When a therapist is included in the feedback, the session often goes much longer than one where it is just me and the client (or family).

96132 and 96133 are the codes I have included for collaboration with referral
Click to expand...

I may not be the best one to advise you on this - maybe someone with more BH experience can respond, or you may want to check with one of the professional societies to see if they have any coding guidance published for situations like this.

My impression here, for what it's worth, is the the feedback session is a component of 96132/96133 but you can't use that code just to bill that component - these codes represent the entire service. It sounds like PsyD and LCSW are splitting this service between them and I'm not sure what's the appropriate way to represent that in coding since each provider is performing a portion of the service but not the entire service. Sorry not to be of more help, but I'll keep an eye out for more information.
 
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The PsyD is providing testing results and feedback to the client. If the LSCW and PsyD are collaborating on treatment options for the client based on the results, all time spent would still fall under the 96133 for the feedback session, with the PsyD.

I find that it is easiest resolve these questions is to refer providers to see the definition of the service as written in CPT. It is clear that the service that the LSCW wishes to charge for doesn't meet the definition of Individual Psychotherapy. The service time for 2 different providers should not overlap, however she could set up a counseling session to meet separately with the client after the PsyD's feedback session on the same day.
 
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