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PhD - billing for 90804, 90806, 90808

  1. #1
    Default PhD - billing for 90804, 90806, 90808
    Medical Coding Books
    Our PhD sees the clients and writes her reports the following day? Can she include the the time that she spend on writing the progress notes?

    Also is 90804, 90806, 90808 limited to just office setting or this can also be done at home, hospital or other outpatient settings?

    Thanks,
    Raquel

  2. Default
    Only face to face time can be included in the 90804.

    The codes can be billed in the office or outpatient setting only.

  3. #3
    Default
    Thanks for the quick help and reply. So she can't bill the 90804, 90806 and 90808 if she does it at home or at the hospital?

    How should we billing for the service she does at home and at the hospital?

    Thanks,
    Raquel

  4. #4
    Default
    By hospital I am assuming it's inpatient. You would use 99221-99223 as appropriate or 90801 for the initial visits and use codes 99231-99233 for follow up days. There are some inpatient therapy codes as well. See your CPT book in the psych section.

    I am not sure about home visits. I dont do those

  5. #5
    Location
    Jacksonville River City FL
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    Default
    I recommend checking payor guidelines as well as local requirements for PhDs since they are usually not able to bill E&M codes. Hospital based codes for PhDs are 90801, 90816, 90818, 90821 for in-patient. Health & Behavior codes can also be used in-patient. The only code I know of for home visits is in the E&M section so would probably not work for you.

  6. #6
    Default
    Quote Originally Posted by 1073358 View Post
    By hospital I am assuming it's inpatient. You would use 99221-99223 as appropriate or 90801 for the initial visits and use codes 99231-99233 for follow up days. There are some inpatient therapy codes as well. See your CPT book in the psych section.

    I am not sure about home visits. I dont do those
    OOPPPSSSS..disregard my post. I know PhD's can't bill EM's.Long day i guess

  7. #7
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    Thanks for all your help with this.

    Raquel

  8. #8
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    Any suggestions on billing 90806 for home visits? Thanks!

  9. #9
    Default
    I'm not 100% sure, but I believe that Medicare will not pay for psychotherapy provided in the home. Our Medicaid will allow CMHC's to bill for therapy in the home but it is a HCPCS code, H004, but again that is specific to our state payer. Our commericial payers don't cover it in the home either.

  10. #10
    Default
    Quote Originally Posted by rnakahara View Post
    Our PhD sees the clients and writes her reports the following day? Can she include the the time that she spend on writing the progress notes?

    Also is 90804, 90806, 90808 limited to just office setting or this can also be done at home, hospital or other outpatient settings?

    Thanks,
    Raquel
    per mental health services billing guide from cms cpt codes 90804-90809 or 90810-90815
    can be use in school,homless shelter,office,patient's home,group home,urgent care,outpt hospital,er room,independent clinic,community mental health and comprehensive out pt rehabilitation facility

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