Wiki SBIRT Codes

[Michelle Martinez]

We have just recently hired a Psychologist in New Mexico, everywhere I have looked, It says he is not allowed to use any E/M. We were just looking at one 99205. The only thing he is doing right now is pyschological evaluations to include using several SBIRT assessments. I can not find a code or how to unbundle for reimbursement of time going over the assessments. The evaluations is 2 hours. 90792 shows codes are bundled.
We are medicaid heavy, not much private insurance. I found H0049 Alcohol & Drug Screening; H0050 ; G0444 for other Assessments; G0397.
In all reality I am coming up with reimbursement of no more than $180. I know it should be alot higher for Psychologist, can someone tell me which codes I can use for one DOS, and is it all only 1 unit (If I put 2 units, it says not allowed) along with do I need a modifier? and how do I unbundle for correct compensation for the screenings. Thank you so much in advance

 

[TThivierge]

Hi Michelle,
Psychologist, LCSW and LPC can bill CPT 90832-90837, groups CPT 90853 not more than 10 in a group setting & note for each patient in group too. CPT 90846-90847 family sessions, Adaptive Beh assessment codes may help too CPT 97151. Also put minutes in med documentation and describe issues pt having in list of Dx or Assessments. If do use CPT 90832-90837 by telehealth video or Zoom use modifier 95 on these codes. Sometimes video not work can transfer to phone call but must tell this fact in documentation& add minutes talk or Zoom video plus list pt permission and verify correct pt at top of record. Phone CPT codes are 98966-98968 but MD/docs use CPT 99441 series for phone calls.

Ensure describe pt problem of dx blocks of F10-F19, F06, F32, F33, F43, Etc. with proper Z dx codes if applicable (dx Z63, Z56, Z59, Z81, Z71) and block dx R45 differ mental health symptoms if apply. If pt has past mental health problem years ago put date this happened, distinguish remission vs current history and types of sub abuse(pills F19-F15 , boozeF10 , ciggies, F17 pot F12 and cocaine F14).Also beh. modification cessation codes...smoking Dx F17.200 CPT 99404-99406 series or lessen booze or diet modification can be used, just add minutes discuss in med record for the day plus linking dx codes. These can be added to the other CPT 90832 codes for BH therapy, then add cessation codes if discussed same date.
Well hope this data helped you
Lady T