E/M vs. 90791/90792

[stosadori@legacytreatment.org]

NJ Medicaid only allows these codes 2 times within 365 days. Would it be possible to to bill 99215 time based in placement of them if needed more than that?

 

[lmchugh]

NJ Medicaid only allows these codes 2 times within 365 days. Would it be possible to to bill 99215 time based in placement of them if needed more than that?

For the 90791 (non prescribers) usually, it's either a 1 and done or they continue on with psychotherapy.
For the 90792 Prescribers usually do the E/M or E/M with psychotherapy after the Initial diagnostic evaluation with Medical services. If you look at the CPT book, these 2 codes are for an assessment or a reassessment if required. If the patient presents with a new problem you should be able to bill again outside of that time period.