Wiki Psych diagnostic vs therapeutic

[Wendy CPC]

Is there a time limit between visits when a social worker can bill a 90801? Does it depend on the diagnosis? I know E/M guidelines state you can not report a new patient visit within 3 years of the same specialty seeing the patient, but does this apply to psychiatry also?

Thank you

 

[smdumpert]

Most insurance companies set the limit. Medicare allows one per year, at least in our area, regardless of provider (LCSW, MD or psychologist). Unless there is a significant change. An then you have to fight to have anything over the one per rolling year paid.