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Wiki LCSW in a private Pain Management Practice.

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celcano

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We are a private Pain Management practice. My physician is exploring the possibility of hiring a licensed clinical social worker to counsel our patient's that are at high risk for medication abuse or addictive behavior. We would administer a "psych test" (CPT 96103). The LCSW would interpret the test and counsel the patient if appropriate. I am having a difficult time getting any definitive answers on what this person can and cannot do. From a Medicare perspective, I can see that the LCSW cannot bill E/M codes nor can 93150 - 93154. Has anyone tried this in their office? Any advice or insight on what we are trying to accomplish?

Thank you!
 
That is correct. LCSWs are unable to bill an E&M service. Typically they would bill out 90832-90838 series, 90791-90792 series, and if pharmacological management is needed the add-on code of 90863 is used in addition to the other codes I have mentioned above. The 96103 includes psychodiagnositc assessment of emotionality, etc. and also includes interpretation and report. If a separate counseling session is needed after the assessment, you would report the codes above with the LCSW. I hope this has helped.

Laura E Chapman, MBA, CPC-A, CANPC
 
Any updated information for 2019 regarding same issue above?
I know CPT code has changed for 96103 to 96130-96131.
Are LCSWs still unable to bill an E/M service?
 
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