Psychiatry Coding & Reimbursement Alert

Question: The new codes for psychotherapy include time spent during psychotherapy with a family member. If that is the case, should I use these new psychotherapy codes (90832-90838) or should I use the family psychotherapy codes 90846 and 90847 when our psychiatrist provides counseling sessions to the family of a patient? I am getting confused.

Georgia Subscriber

Answer: When your psychiatrist interacts with family members during a psychotherapy session, you will have to determine the intent of the interaction in determining if you will use the new psychotherapy code ranges (90832, Psychotherapy, 30 minutes with patient and/or family member-+90838, Psychotherapy, 60 minutes with patient and/or family member when performed with an evaluation and management service [List separately in addition to the code for primary procedure]) or use the family psychotherapy codes, 90846 (Family psychotherapy [without the patient present]) or 90847 (Family psychotherapy [conjoint psychotherapy] [with patient present]).

If the service provided during the psychotherapy session is oriented around the patient with some peripheral involvement of the family by your psychiatrist, you will have to use the psychotherapy codes 90832, 90834, or 90837, depending on the time spent on the psychotherapy, or report an E/M code with add-on psychotherapy codes +90833, +90836, or +90838, if the session involved an E/M service and psychotherapy.

If the session was oriented towards the family and how their interactions would benefit or affect the patient being treated, then you will have to use the appropriate family psychotherapy codes, 90846 or 90847, depending on whether or not the patient was present during the session. Here, even though the objective of the psychotherapy session is to benefit the patient, the session is oriented towards how the actions of the family will help the patient and not oriented towards therapy for the patient alone.