Question Psychotherapy Services

larcher614@gmail.com

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Does anyone know if specific start/stop times have to be documented in the note to be billable for psychotherapy? I know that they must be documented when billing psychotherapy and an E/M, but would "total time" be compliant documentation for psychotherapy? Any help would be appreciated. Thank you!
 

larcher614@gmail.com

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Okay, thank you! I have been researching and found conflicting information. I was taught that total time documented would work, even though start/stop times are preferred. I checked our Medicare MAC and it did not specifically state anything about start/stop time, only that time has to be documented. Just wanted to see if anyone else had further information. Thank you for your help and this information!
 
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Bellingham, WA
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welcome!
I have a question for you!
we have started a parenting support group and the clinicians are billing under the patient (child).
I don't think it should be billed under the patient's insurance but rather the parent's insurance.
Here's a snip of the group note.
They think it can be billed under Family Group Psychotherapy - which would make sense if there were other family members and/or case managers, school counselors - people of relevance to the patient in the group.
The group includes other parents - and I don't see them as "relevant" to the patient.
What do you think?

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SharonCollachi

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Clovis, CA
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Defining 90849 and 90853
The CPT codes 90849 and 90853 are used when people with similar issues or conditions are treated in a group. Whether that’s a few families trying to reconcile after a spouse cheats or individuals with depression seeking support, the session must use psychotherapy to qualify for the codes and the issue must be best treated in a group setting.

What distinguishes the two codes is the type of patient: 90849 is for multiple-family group psychotherapy and 90853 is for general group psychotherapy. This affects who can attend the session. Whereas multiple-family group psychotherapy will have family members in attendance, general group psychotherapy will only have the individual clients present.

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90853 is several patients, no non-patients, family members, etc.
90849 is for several families, with patient present

If parents are learning how to parent, I would call that 90853, and bill each participant under their own insurance. That means mom is a patient, dad is a patient, etc.

The child, who is the subject of discussion, is not engaging in psychotherapy, is not being taught how to change their thinking or behaviors, etc., therefore, no services are being provided to the child. The child is not a patient for this scenario (they may be in counseling separately, which is a different issue).

Also look at the interactive complexity add-on code, which is probably applicable, 90785.

If the insurance accepts it, there is an S code for parenting classes, S9444.

You might also want to check CPT Assistant, if you subscribe to it.
 
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