# 2 visits one day - we have a psychiatrist on staff



## ljfreeman (Feb 26, 2013)

we have a psychiatrist on staff.  Can he see the same patient in one day for psychiatric and medical care and charge 2 visits?  Or if he sees the patient for psychiatric care and the patient sees another provider in the same clinic on the same day but different diagnosis can we bill 2 visits? Will insurance companies allow this?


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## johnmeyer (Mar 3, 2013)

That would depend on the type of care the patient is receiving.

I work in an orthopedic clinic (we have surgeons on staff). The only way one of our patients can see more than one provider per day is if one of their visit is related to surgery, which needs to be in their global period. This even includes regular office visit and physical therapy on the same day as we have a physical therapy department. They can’t have physical therapy and be seen in our clinic on the same day unless they are in their global period after surgery.

This holds true regardless of the diagnosis. Even if they were to see our foot/ankle specialist for an ankle sprain and then our hip/knee specialist for osteoarthritis of the knee on the same day, one of those doctors would have to eat their charge because no insurance company would pay for both on the same day, again unless one of the visits was in a global period after surgery.

So in your case, it depends… Will this patient be seeing another mental health professional on the same day? If so, I’d say probably not.

As far as being able to charge two separate visits by the same provider… I’m really not sure about that. I think it would depend on what CPT code you’re going to use. I know that sometimes we see patients that are in a global period (99024) and we end up seeing them for something else at the same time (like a 99213). Then you could use the -24 mod on the 99213.


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## mitchellde (Mar 3, 2013)

Psych is a little different than other specialties and the code are constructed different.
If the psych doc sees the patient and performs a medical exam in addition to a psych counseling you code the E&M and use an add on psych code for the counseling, you need to read the rules on this though regarding the timing. but briefly:
* the E&M must be based on the 3 key components only and not based on time
* the psych counseling must be a minimum of 16 minutes beyond the E&M part 
If you have docs of different specialties in the same office, then a medical doc may see the patient for the medical portion and charge an E&M 
the psych doc will charge the non add on psych counseling codes and must be based on time


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