Psychiatry Coding & Reimbursement Alert

Question: In our group practice, two of our psychiatrists are holding psychotherapy sessions for two siblings. Now they are intending to have a family therapy session with them with both the clinicians being present. Should I bill individual psychotherapy codes or family codes for the session? Also, let me know if we have to bill for both or only one of them.

Dallas Subscriber

Answer: Since your clinicians are planning to have a family therapy session involving both the siblings in one session, it can be assumed that the session is being conducted with the focus on how each one’s behavior and interaction will help benefit and improve the effects of the other sibling’s treatment.

So, in such a case, since the focus is on the other sibling’s interaction, it is best to report a family therapy code rather than an individual psychotherapy code. As the siblings are both present in the session, you can report 90847 (Family psychotherapy [conjoint psychotherapy] [with patient present]) for the session.

This family psychotherapy code may be separately reported for each patient in the family group. As each of the siblings is a patient under the care of one of your psychiatrists, and both the siblings are participating in the family session, you will report 90847 for each of these patients with their individual diagnosis codes. Since the siblings are being seen by two different clinicians for their individual psychotherapy sessions and both clinicians are present for the family psychotherapy session, you may report the family therapy code using the respective clinician’s physician identification number (if they are reporting separately) or use the group identification number.