I'm not familiar with these codes at all, but maybe it's worth a look? I know there are a LOT of parenthetical notes but I found several places that used these three codes together: 99213, +90836, +90875
When I pull 90785 up online it says:
"90785 Interactive complexity (List separately in addition to the code for primary procedure)
Notes:
(Use 90785 in conjunction with codes for diagnostic psychiatric evaluation [90791, 90792], psychotherapy [90832, 90834, 90837], psychotherapy when performed with an evaluation and management service [90833, 90836, 90838, 99201-99255, 99304-99337, 99341-99350], and group psychotherapy [90853])
(Do not report 90785 in conjunction with 90839, 90840, or in conjunction with E/M services when no psychotherapy service is also reported)
(Do not report 90785 in conjunction with 90839, 90840, 0364T, 0365T, 0366T, 0367T, 0373T, 0374T)
This add–on code represents communication factors that add to the difficulty of service delivery and increase the intensity of effort required of the provider in a particular treatment session. There are various factors that make the psychotherapy session more intensive in effort like high reactivity or disagreement among family members, emotions or behavior of the caregiver that hinder execution of the treatment plan, situations involving abuse or neglect that the provider must legally report, use of play equipment or other objects to assist communication, or the need for an interpreter or translator because of the patient’s lack of fluency or undeveloped verbal skills. [It mentions elsewhere that difficulty in communication is acceptable as long as that difficulty is specified and an explanation of how it affected the visit are included in the provider's note]
This code can be reported with code(s): 90791, 90792, 90832, 90834, 90837, 90833, 90836, 90838, 90853"
Here's what I found for 90836:
"90836 Psychotherapy, 45 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)
Notes:
(Use 90836 in conjunction with 99201-99255, 99304-99337, 99341-99350)
In this add on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient in addition to an evaluation and management service in the same session. The treatment session typically lasts for anywhere between 38 to 52 minutes and may or may not involve the patient’s family members.
Psychotherapy is a type of therapy in which the provider uses a series of techniques to treat the mental and emotional health problems of a patient. Psychotherapy includes the interactive process between the provider and the patient. The provider involves the patient in this therapeutic interaction with the aim to explore the thoughts, feelings, and behavior of the patient. The provider uses a variety of techniques based on relationship building, communication, and behavior change that target improvement of the mental health of the patient. For this code, the provider should spend approximately 45 minutes but no less than a minimum of 38 minutes and a maximum of 52 minutes face to face with the patient and or a family member in addition to the evaluation and management service performed in the same session.
Bill this code separately in addition to the code for the primary evaluation and management service.
Tips
Use code 90834 when the provider performs a psychotherapy session for 38 to 52 minutes without an additional evaluation and management service in the same session.
Because +90836 is an add–on code, payers will not reimburse you if you report it without an appropriate evaluation and management service code, specifically 99201–99255, 99304–99337, 99341–99350."
