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What code do I choose for a non-licensed MH provider

  1. Default What code do I choose for a non-licensed MH provider
    Medical Coding Books

    I am struggling with what code to use to bill for a counseling session provided by a non-licensed mental heatlh provider.

    Would I choose the 90804 or 90806 and indicate a modifier to disquish the licensing with non licensing?

    Any information is appreciated!

  2. #2
    I am not entirely clear what exactly you mean by non licensed practitioner. Are you certain that this person is within their scope of practise? If I had to say, I would be thinking the 90804 or 90806 type codes, nothing with EM as I assume this isnt or cant be a MD.

  3. #3
    Louisville, KY
    E/M codes are inappropriate. Also, I am not certain--given the "non-licensed" status of this provider--what to recommend.

    Depending on what services are being furnished to the patient, check out the H-code section of HCPCS, as this tends to be the default for mental health providers who do not fit into the LIP category.

  4. #4
    By saying non-licensed do you mean an intraining practitioner/intern? Someone working on their necessary hours to become licensed? if that is the case be very careful and make sure you check all policy, rules and regs to make sure that you can bill for those services. Some states require so many hours before licensing and billing.

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