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Psych diagnostic vs therapeutic

  1. #1
    Spokane WA
    Default Psych diagnostic vs therapeutic
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    Is there a time limit between visits when a social worker can bill a 90801? Does it depend on the diagnosis? I know E/M guidelines state you can not report a new patient visit within 3 years of the same specialty seeing the patient, but does this apply to psychiatry also?

    Thank you

  2. #2
    Most insurance companies set the limit. Medicare allows one per year, at least in our area, regardless of provider (LCSW, MD or psychologist). Unless there is a significant change. An then you have to fight to have anything over the one per rolling year paid.

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