Wiki PhD - billing for 90804, 90806, 90808

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rnakahara

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Our PhD sees the clients and writes her reports the following day? Can she include the the time that she spend on writing the progress notes?

Also is 90804, 90806, 90808 limited to just office setting or this can also be done at home, hospital or other outpatient settings?

Thanks,
Raquel
 
Only face to face time can be included in the 90804.

The codes can be billed in the office or outpatient setting only.
 
Thanks for the quick help and reply. So she can't bill the 90804, 90806 and 90808 if she does it at home or at the hospital?

How should we billing for the service she does at home and at the hospital?

Thanks,
Raquel
 
By hospital I am assuming it's inpatient. You would use 99221-99223 as appropriate or 90801 for the initial visits and use codes 99231-99233 for follow up days. There are some inpatient therapy codes as well. See your CPT book in the psych section.

I am not sure about home visits. I dont do those
 
I recommend checking payor guidelines as well as local requirements for PhDs since they are usually not able to bill E&M codes. Hospital based codes for PhDs are 90801, 90816, 90818, 90821 for in-patient. Health & Behavior codes can also be used in-patient. The only code I know of for home visits is in the E&M section so would probably not work for you.
 
1073358 said:
By hospital I am assuming it's inpatient. You would use 99221-99223 as appropriate or 90801 for the initial visits and use codes 99231-99233 for follow up days. There are some inpatient therapy codes as well. See your CPT book in the psych section.

I am not sure about home visits. I dont do those
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OOPPPSSSS..disregard my post. I know PhD's can't bill EM's.Long day i guess
 
I'm not 100% sure, but I believe that Medicare will not pay for psychotherapy provided in the home. Our Medicaid will allow CMHC's to bill for therapy in the home but it is a HCPCS code, H004, but again that is specific to our state payer. Our commericial payers don't cover it in the home either.
 
rnakahara said:
Our PhD sees the clients and writes her reports the following day? Can she include the the time that she spend on writing the progress notes?

Also is 90804, 90806, 90808 limited to just office setting or this can also be done at home, hospital or other outpatient settings?

Thanks,
Raquel
Click to expand...
per mental health services billing guide from cms cpt codes 90804-90809 or 90810-90815
can be use in school,homless shelter,office,patient's home,group home,urgent care,outpt hospital,er room,independent clinic,community mental health and comprehensive out pt rehabilitation facility
 
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