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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
    Location
    Louisville, KY
    Posts
    1,101
    Default
    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
    Default
    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
    Default
    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:
    http://www.trailblazerhealth.com/Too...s.aspx?ID=2870

    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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