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Thread: Pysch intern coding help

  1. #1

    Question Pysch intern coding help

    AAPC: Back to School
    I work for a pain management doctor and he has a psych doctor come into our office to do pysch evaluations before they implant a stimulator or pump in a patient. This psych dr would like to have his interns come to our office and do the evals, but the pysch dr will be at his own office, so the intern will be on his own. Who would get to bill for the psych eval at that point....my physician? Any help on this would be appreciated, I have never heard of such a thing before.

  2. #2
    Join Date
    Apr 2007
    Louisville, KY


    You only describe this person as a "psych doctor." Is this a PhD or PsyD Psychologist or a Psychiatrist (MD/DO)?

    If the provider is a psychologist, his/her intern would still be considered a student and you could not bill for any services supplied to Medicare/Medicaid patients and expect reimbursement. Student services are never billable under those programs, and usually not to any third-party insurers either.

    The "intern" may be interning for a psychiatrist. This would fall under Medicare Resident Supervision Guidelines, but would require that these intern providers have their license. They'd have had to graduate medical school and pass the state licensing exam . . . at least as far as I know. I am not an expert on the Medicare Supervision Guidelines for Residents, as my employer uses a different set of guidelines.

    Please be sure you search for the Medicare rules on students and residents before agreeing. This may not be a service that you can recoup money on, just so you know.

    Good luck!
    Kevin B. Shields, RHIT, CPCO, CCS, CPC, COC, CCS-P, CPC-P, CPC-I

  3. #3


    Thank you Kevin! And it is a Psychologist that has the intern. So what you are saying is that we cannot bill for the intern seeing the patients on his own. Even if the psychologist reviews and signs off on what the intern does? What if the psychologist performs most of the visit requirements, but leaves the intern to some of them?

    I was reading up on the Medicare guidelines and to me it felt as though they consider interns to be somewhat like a PA would be. As long as the MD is close by, you would be able to bill for their services. I don't know...one minute I feel like I understand what I am looking at, then I read another sentence and I go back to square one where I am completely lost! Help!

  4. #4
    Join Date
    Apr 2007
    Louisville, KY


    A Psychology Intern is always a student--in as far as I know. Medicare clearly states that student services are non-billable. This means that the "intern" could only take history--much like an LPN in the practice. The objective assessment and final diagnoses and decision making, must be by the licensed provider only (psychologist), that includes any testing interpretation and psychotherapy services done during the visit.

    Interns are not residents. Fundamental to understanding what is allowable is knowing the various provider levels. Understand that when you talk about this "intern" he/she is a student for all purposes. Follow only the information Medicare provides on students . . . that should keep you straight.

    I hope this is helpful.
    Kevin B. Shields, RHIT, CPCO, CCS, CPC, COC, CCS-P, CPC-P, CPC-I

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