Wiki PROVIDER SERVICES WITHOUT THE PATIENT PRESENT

[mwells2020]

One of our providers had a Telehealth visit with a patient's mom & care team without the patient present. I unable to find how to bill for this? I sat on a webinar in April & it stated that we are unable to bill an E/M & we are unable to bill insurance. So, is there a generic code to use when billing this? I have looked at the Care Plan codes & none of them seem to fit. This visit was for a 25 year old female with Intermittent Explosive Disorder, Intellectual Disability, & Dravets Syndrome.

 

[csperoni]

My understanding is that Medicare does not allow E&M services when patient is not present. Commercial carrier requirements could differ.
CPT code 90887 Interpretation or explanation of results from psychiatric, OTHER MEDICAL EXAMS & PROCEDURES, or OTHER ACCUMULATED DATA to FAMILY or other responsible persons, or advising them how to assist patient (my caps for emphasis on relevant phrases) seems like it would be the accurate code, but it falls under the heading of "Other Psychiatric Services or Procedures".
In my practice, we do occasionally encounter this situation and use 90887 (just for tracking) with zero charge - nothing billed to insurance. We do not charge the family and consider it a good deed for the day.