Psychiatry Coding & Reimbursement Alert

Question: Our clinical psychologist provided behavioral psychotherapy in the office for a patient suffering from generalized anxiety disorder. The entire visit lasted for a total of 45 minutes. The patient's spouse was present during the entire visit to provide comfort to the patient by her presence. Do I have to use a family therapy code to report the visit or should I use individual psychotherapy codes itself?

New York Subscriber

Answer: Family psychotherapy codes such as 90847 (Family psychotherapy [conjoint psychotherapy] [with patient present]) are to be used when psychotherapy is provided to the patient and counseling is provided to the family to understand the problem being faced by the patient. The family is also instructed on how to deal with the patient's problems and the ways in which interpersonal relationships can be improved to be helpful in improving the patient's condition. The discussions with the patient's family might also be helpful for the psychologist or the psychiatrist in understanding more about the patient's condition and that will, in turn, be helpful in devising an appropriate treatment plan.

But if the presence of a family member is only for the purpose of providing emotional comfort to the patient during the therapy and the main focus of the treatment is individual psychotherapy, then it is not appropriate to use family psychotherapy codes such as 90847 as is the case in the scenario you have described. Instead, you will have to choose the most appropriate individual psychotherapy code to report the visit.

So in this case, you can use 90806 (Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately 45 to 50 minutes face-to-face with the patient) as the therapy session took place in the office, the session lasted for a period of 45 minutes and there was no apparent medical evaluation and management involved.