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What to bill for Sexual Addiction Therapy? What is the average cost of Therapy?

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Hi All,

I am learning to bill for Mental Health and Substance Abuse services. I have substance abuse area down as we use H Codes for these services. But I am having a hard time finding what code to use for Sexual Addiction therapy. I'm sure you know that family, group, and individual therapy is all used to treat for Sexual Addiction but can anyone help me as to what codes to use?

Also, what is a standard price for sexual addiction therapy? I have a provider who is really struggling with these codes and would like the best help possible.

Thanks!
 

Pam Brooks

True Blue
Local Chapter Officer
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Dover Seacoast New Hampshire
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There's no ICD-9 code for Sex additiction that I could see, but I'd suggest you look at 302.89, Other psychosexual disorders.

Also, individual, group or couples counseling is appropriate for any psychological diagnosis, so there's no specific CPT code for Sexual Addiction treatment; you identify that through the diagnosis.

I'd be sure to get pre-approval from your payer. Some of these conditions are not yet considered medically necessary.

And your rates are set by either your payer's fee schedule, or as a percentage of Medicare. It's up to you what you charge, but you have to adjust off the balance not covered by any payer you participate with, unless your entire population is self-pay. You can't charge a different price for the same CPT code, however, just because of the diagnosis.

Hope this helps. Pam
 
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