Wiki BILLING FOR 90849 vs 90853 - MENTAL HEALTH GROUP SESSIONS

[Suzbarrett16]

Hopefully someone can help me with billing group session participation. I have a provider that wants to host group sessions for several different families together. As an example, it would be 3 or 4 couples processing a topic that is on all of their treatment plans. Since it is a group session with psychotherapeutic modalities utilized, how do I bill each participant in group? Would I use 90849 or 90853? None of the participants have Medicare; I have seen both codes on different payer fee schedules. UHC has the only descriptor that I can find: "Optum will only reimburse for one of the family therapy codes per day and any subsequent claims for the same family, on the same date of service with the same provider will be denied. (90846, 90847, 90849)"

Has anyone used 90849 and can I bill for each individual in the group with this code?

 

[TThivierge]

Hi Suzbarett16,
I 'd bill CPT 90849 with each person needs a note who attend this multi family group, but if payer states different do not do it. You code it but therapist needs to do the documentation of course. From the note info with Optum it seems only one of the married couple (hubby or wife) can be covered in same group on same date. Thus do a note for Mr or Mrs not both.
Well I hope this helps you
Lady T