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Unusual scenario...

  1. #1
    Default Unusual scenario...
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    In our office we offer hypnotherapy one evening a week. We checked with our carriers, and most do not cover hypnotherapy. So we have only been offering it to patients who were willing to pay for the service out of pocket. The following question was asked by one of our providers, and we are looking for opinions on this:

    Hypnotherapy is entirely face-to-face time. Do you think there is a way that we could bill the visit based on time? (as the insurance carriers will cover a 99214/99215) The visit typically runs 45 minutes. What do you think would have to be documented in the note in order to bill this as a 99215?

  2. #2
    Katkia, remember that 99214 and 99215 are E/M services, which can be based on counseling and coordination of care time (if it dominates the visit). However, hypnotherapy (90880) is listed under CPT as a Psychiatric service, so the E/M time determination would not apply. You'd be running a very slippery slope indeed if you reported hypnotherapy based on time (90880 does not have a time descriptor like other psych codes.)

    I think in this case I'd stick with the "You may be responsible for charges not covered by your insurance" clause or self-pay. At least if they don't pay, you can rifle their pockets while they're under! Just kidding - that would be wrong.

    My two cents,

  3. #3

    Thanks, I agree. That is pretty much what I told them, that hypnotherapy was not an E/M visit and as such billing it as counseling would be incorrect. Their question was basically...."but since the hypnotherapy code begins with a 9, and the hypnotherapy is being done to manage the patients disease, wouldn't that mean it is from the Evaluation and Managment section?" My employers trust me, but they want to see if other coders/sources agree with my opinion before making a decision.

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