I would like to pose a coding question. We have a physiatrist attending supervising residents at a practice. We are understanding that the attending has to be present the full time with the resident while they see the patient per Time-Based Codes section within Guidelines for Teaching Physicians, Interns, & Residents MLN006347 August 2023 page 7 for psychotherapy codes: Individual medical psychotherapy (CPT codes 90804–90829) . If the attending is not present the full time while the resident sees the patient, can these be billed as E/M codes instead of psychotherapy visits? The chart notes read like psychotherapy notes. However, even though they are not doing medication management, in these psychotherapy appointments the patients still present with the same complexity that they evaluate and manage for as psychiatrists, and also still have some risk level that they also evaluate and manage for as psychiatrists. A referenced E/M chart from APA utilizes an example of "Diagnosis or treatment significantly limited by social determinants of health" as an example for Moderate Risk (99214). It does not appear to necessitate Medication Management. Additionally, according to another resource, it states for E&M codes: "Assessment may include history, symptoms, mental status, and rating scales (self-rated scales are allowed). A problem counts if it is “assessed or treated,” meaning problems treated by another clinician may count if they warrant an assessment (eg, metabolic syndrome, sleep apnea, stroke). Treatment includes any service you provide, from meds to therapy, as well as treatments you recommend but the patient declines. Treatments that are continued count the same as those that are changed, but treatments that involve higher risks may count more in the next category." An example of documentation the provider would use, "On intake, the patient reported a previous diagnosis of PTSD and associated symptoms of occasional flashbacks, hyperarousal, hypervigilance, and negative alterations in cognition and mood, all of which the patient continues to endorse. The patient also has social determinants of health, including problems related to employment and unemployment, problems related to upbringing, and problems related to other psychosocial circumstances." Could an E/M be supported in place of a psychotherapy CPT code based off of medical decision making?