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90853 code

pamela 4 years ago in Codes/Rates/Diagnosis Modules updated by crystalp 4 years ago 3

Can anyone give me suggestions as to how we can get paid for two different psychotherapy groups that are offered on the same day? We currently have a women's group and a parenting group with clients in both group. Since we are billing a "90853", the system will only allow us to bill for this once in a day. Thoughts?


Pam

You can't get paid for the same client for multiple MH visits in one day.

Have you tried using the "59" (distinct procedure) modifier? We have not but are just looking into this as well. Please let us know either way.

You can also try modifier 76- repeat procedure by same physician OR modifier 77 which is repeat procedure by another physician. It's possible only certain payers accept those modifiers though. I've heard Medica PMAP accepts these but have not tried myself.