Wiki Psychotherapy Billing

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ECaldwell

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Hi, I have a question about psychotherapy billing. I have seen that when billing for crisis psychotherapy services, the total billable time for face to face interaction does not need to be continuous. Does anyone know if there is any guidance suggesting that non-crisis psychotherapy could also be billed as non-continuous time? (Ie if a patient has a 30 minute session, takes a break, and comes back for continuation of that session).
Thank you.
 
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Interesting question. I would say what is important here is why is it being done? And is it logical? Are you taking a potty break in the middle of a session? No big deal. But say you do 30 minutes, then the patient comes back 2 hours later for 15 minutes. What is the reason for that? How much can you get done in 15 minutes? Was it necessary? In all my years in mental health, I've never had this scenario!!

I was able to find, through the American Academy of Child & Adolescent Psychiatry, that they mentioned when billing for Prolonged Services (add on codes), the time must be on the same day but does not have to be continous.

I also turned to my CPT book, and found the same thing.

I think the reason that the CPT book is specific about crisis services, is that it is more likely to NOT be continuous time than it is to be continuous time, so they spelled it out. To me, that does not mean the other codes must be continuous.

So is this a one-off thing or something that is happening regularly? Inquiring minds want to know!
 
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Thank you for the reply!
I saw the crisis and prolonged services descriptions which is helpful. I'm in a dynamic behavioral health facility that does functional behavioral health along with speech and occupational therapies with TBI patients. That population is often behavioral and end up needing brief, but very frequent interactions by Psychologists to manage their behaviors and process the emotions or activities causing the behaviors.

I made the same presumption that just because they spelled out continuous time in the prolonged and crisis codes, that it doesn't mean that the other codes must be.
 
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SharonCollachi said:
Interesting question. I would say what is important here is why is it being done? And is it logical? Are you taking a potty break in the middle of a session? No big deal. But say you do 30 minutes, then the patient comes back 2 hours later for 15 minutes. What is the reason for that? How much can you get done in 15 minutes? Was it necessary? In all my years in mental health, I've never had this scenario!!

I was able to find, through the American Academy of Child & Adolescent Psychiatry, that they mentioned when billing for Prolonged Services (add on codes), the time must be on the same day but does not have to be continous.

I also turned to my CPT book, and found the same thing.

I think the reason that the CPT book is specific about crisis services, is that it is more likely to NOT be continuous time than it is to be continuous time, so they spelled it out. To me, that does not mean the other codes must be continuous.

So is this a one-off thing or something that is happening regularly? Inquiring minds want to know!
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I need some advise, patient comes in for a 50 minute Psychotherapy visit and finishes the session, later that day patient comes back and it is deemed a crisis visit and we spend an additional 90 minutes with the patient. Do we have to forgo billing the 90834 and only bill for 90839 and 90840 because they code book says that 90834 and 90839 can not be billed together. Help please and thank you
 
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