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Psych Eval

  1. #1
    Default Psych Eval
    Medical Coding Books
    If a patient has not been seen in awhile and comes back to see the provder, can the provider bill for a "New" Psych eval or is it like an E/M every three years? I am new to Behavioral Health Services. Thanks for your help in this matter.

  2. #2
    Louisville, KY
    How long is awhile and has the patient's condition changed substantially since last time?

    Also, we'd need to discuss the payer's policy on psych evaluations.

  3. #3
    Months and I am not sure if their condition has changed. Patient has been non-compliant with visits and provider feels he can do another Evaluation after the patient chooses to come back. Commerical insurance. Thanks for you reply.

  4. #4
    Hi NE Smith,

    I just looked up a link for Psych coding on trailblazer local coverage determination.

    Mental health services are billed by procedure codes, not E&M codes so there are no new or established codes like in E&Ms.

    The initial assessment is 90801 and f/u or psychotherapy codes are 90804-9 depending on the provider type.

    Check out this link:

    Per medicare you are only allowed to bill 3 90801s per year.

    To bill a 90801 after the first initial assessment, the patient would have to be assessed for a new/different dx than during the first initial assessment.

    Hope this helps
    The Oracle

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