Mental Health Phone Appointments

agrebiner

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Hello I work for an LCSW.

Is it appropriate to bill for a phone appointment?

If so is there a specific code for this? Or just the 90837 code?

Please help!
 
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The guidelines for 90832-90838 state "Psychotherapy times are for face-to-face services with patient and/or family member. The patient must be present for all or some of the service." so if the psychotherapy is done via telephone, it wouldn't meet the face-to-face criteria.

The rules vary state-to-state and also among payers. I posted info about telehealth on this thread https://www.aapc.com/memberarea/forums/140281-code-gt-modfier.html that will probably help you the most.
 

agrebiner

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The guidelines for 90832-90838 state "Psychotherapy times are for face-to-face services with patient and/or family member. The patient must be present for all or some of the service." so if the psychotherapy is done via telephone, it wouldn't meet the face-to-face criteria.

The rules vary state-to-state and also among payers. I posted info about telehealth on this thread https://www.aapc.com/memberarea/forums/140281-code-gt-modfier.html that will probably help you the most.

According to the article link you posted from Medicare it says that you CAN use 90837 for telemedicine. I feel really confused about what is allowed and what isn't. When I find articles like that packet from Medicare... it says that its allowed but not over the phone... but apparently it doesn't need to be face to face..but then when you look up the guidelines to the code itself it says face to face... so does a video chat count as face to face since that IS considered viable telemedicine?

We are located in VA where apparently the law is in our favor for telemedicine. I am so confused
 
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According to the article link you posted from Medicare it says that you CAN use 90837 for telemedicine. I feel really confused about what is allowed and what isn't. When I find articles like that packet from Medicare... it says that its allowed but not over the phone... but apparently it doesn't need to be face to face..but then when you look up the guidelines to the code itself it says face to face... so does a video chat count as face to face since that IS considered viable telemedicine?

The document from Medicare is Medicare-specific. In order to use 90837, you have to meet the criteria for Originating Site as well as verifying the Distant Site Practitioner is an accepted provider-type to conduct the service.
You can check here for additional information as well: https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/index.html

Commercial payers will be different. You will have to check with each payer to verify coverage as it can vary across payers as well as across various plans a payer may offer.
 
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