Psychiatry Coding & Reimbursement Alert

Published on Wed Mar 19, 2014 PDF

Question: Our psychiatrist is of the opinion that when billing for psychotherapy sessions, we can calculate time spent with the family members to add up for total time. Also, he is saying that the patient need not be present for the entire session for us to bill a psychotherapy service. Is this correct?

Michigan Subscriber

Answer: Because the codes for reporting psychotherapy services, 90832-90838, carry the descriptor, “Psychotherapy, …with patient and/or family member,” you can report these CPT® codes when your psychiatrist performs a psychotherapy service to the patient or interacts with the family members during the session.

So, when calculating the time, you can aggregate the time spent for the psychotherapy performed on the patient as well as the time spent in interacting with the family members during the session. You will have to total the time and select the appropriate psychotherapy code. For example, if your clinician spent 35 minutes for the psychotherapy session with the patient and spent another 10 minutes with the family members, you’ll have to total the time and report 90834 for 45 minutes spent on the session. You should not report 90832 taking into view only the time spent with the patient.

However, what your clinician is saying about the patient not necessarily being present for the entire session is not correct. CPT® guidelines for these psychotherapy codes state that the patient needs to be present for the entire service or at least for some part of the service. So, if your clinician is only interacting with the family members and the patient is not present for the entire session, you’ll have to report 90846 (Family psychotherapy [without the patient present]) and not a psychotherapy code.

Note: 90846 is not a time based code. So, irrespective of the time spent for the session, you’ll have to use the same CPT® code and only report it once for one calendar date of service.