AAPC - Back to school
Results 1 to 2 of 2

Thread: Coding for group/individual sessions at a substance abuse facility

  1. #1

    Default Coding for group/individual sessions at a substance abuse facility

    AAPC: Back to School
    I have just recently started a job at a substance abuse facility. We offer both group sessions (billed under 90853, lasting approximately 1.5 hours) and one-on-one sessions (billed under 90804 and 90806, lasting between 30 minutes and an hour). If a patient comes in and has both a group session and a one-on-one session in the same day we bill only for the group session. It seems to me there should be some modifier to allow for billing of both services, much like the -25 modifier for E/m. When I asked, none of the other staff (none of whom have any coding background) could help me. Due to the nature of our treatment, 95% of our clients are billed to medicaid/managed medicaid, if that has any effect on the issue. Is there a way to bill for both services?

  2. #2


    You can bill both. per CCI edits, append mod 59 on 90804 or 8

Similar Threads

  1. Substance Abuse Facility/BioFeedback
    By robertjsenese in forum Behavioral Health
    Replies: 0
    Last Post: 09-17-2015, 02:35 PM
  2. Substance Abuse Facility Consultant
    By kortiz in forum Behavioral Health
    Replies: 1
    Last Post: 04-16-2015, 02:46 PM
  3. Substance Abuse Facility Billing
    By RDGLADISH in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 03-21-2012, 07:52 AM
  4. Billing for group/individual sessions at a substance abuse facility
    By gryphonkessira in forum Billing/Reimbursement
    Replies: 3
    Last Post: 07-14-2010, 07:35 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.