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Psychiatry - 90801

  1. Default Psychiatry - 90801
    Medical Coding Books
    I thought that only a psychiatrist could bill 90801. A psychologist where I work showed me this article: http://psychcentral.com/lib/2007/cpt...logy-services/

    Any thoughts?

  2. #2
    Location
    Rose City (Portland, Oregon)
    Posts
    321
    Default
    A psychologist may also bill for this code. Here is a direct passage from Noridian about what codes each type of professional can bill:

    Only the following types of individuals, when they are performing within their authorized scope of clinical practice under the state law where the service is performed, are qualified to perform the indicated diagnostic and/or therapeutic psychological services under the “incident to” provision:

    1. Doctorate level psychologists (Specialty Code 68): 90801, 90802, 90804, 90806, 90808, 90810, 90812, 90814, 90816, 90818, 90821, 90823, 90826, 90828, 90845, 90846, 90847, 90849, 90853, 90857, 90880, 90899

    2. Doctorate or Masters level social workers (Specialty Code 80): 90801, 90802, 90804, 90806, 90808, 90810, 90812, 90814, 90816, 90818, 90821, 90823, 90826, 90828, 90846, 90847, 90849, 90853, 90857, 90899

    3. Nurse Practitioners (NPs) (Specialty Code 50): 90801, 90802, 90804, 90806, 90808, 90810, 90812, 90814, 90816, 90818, 90821, 90823, 90826, 90828, 90846, 90847, 90849, 90853, 90857, 90880, 90899, (Also, if authorized by the state to prescribe medication: 90862, 90805, 90807, 90809, 90811, 90813, 90815, 90817, 90819, 90822, 90824, 90827, 90829)

    4. Clinical Nurse Specialists (CNSs) (Specialty Code 89): 90801, 90802, 90804, 90806, 90808, 90810, 90812, 90814, 90816, 90818, 90821, 90823, 90826, 90828, 90846, 90847, 90849, 90853, 90857, 90880, 90899, (Also, if authorized by the state to prescribe medication: 90862, 90805, 90807, 90809, 90811, 90813, 90815, 90817, 90819, 90822, 90824, 90827, 90829)

    5. Other psychotherapists licensed by the state to perform psychotherapy, e.g., licensed marriage and family therapists: 90804, 90806, 90808, 90810, 90812, 90814, 90846, 90847, 90849, 90857, 90880, 90899)

  3. Default
    AH - incident to. The article did not mention incident to. So in other words a psychiatrist (MD) must be "supervising" in order to bill.

  4. #4
    Unhappy 96150 - Licensed Social Workers?
    What about CPT code 96150? I know for Medicare it has to be a Psychologist. But what about the other insurance carriers? What I am looking for is an Emergency Behavioral Medicine CPT code(s) I can use for Licensed Social Workers? Thanks!

  5. #5
    Location
    Louisville, KY
    Posts
    1,101
    Default
    I do not believe that "incident to" herein mentioned relates to any supervision by a psychiatrist. It is within the scope of practice of a psychologist to perform this service.

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