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Billing Family Psychotherapy on same date as new patient E & M

Melissa Posted Thu 08th of August, 2019 14:48:46 PM
There is a CCI edit for 90846 and 99205 but a modifier is allowed. so can these be billed together with the use of the 25 modifier?
SuperCoder Answered Fri 09th of August, 2019 04:15:03 AM

Hello Melissa,

Thank you for your question.


Evaluation and Management (99205) may be billed on the same day as (90846) if therapy and evaluation and management have two separate notes by the provider and both the codes meets the component requirements.


For 99205

  • A comprehensive history;
  • A comprehensive examination;
  • Medical decision making of high complexity.

Typically, 60 minutes are spent face-to-face with the patient and/or family.


For 90846


Family psychotherapy (without the patient present), 50 minutes


In this therapy, a provider or qualified psychotherapist meets with a patient’s family without the patient present to counsel the family members and help them understand the patient’s problem and how they respond to the patient can negatively affect or benefit the patient. The emphasis during family psychotherapy is on the patient's care and the family’s involvement in the patient’s treatment.


Note: To rule out the bundling between both the codes, add modifier-25 to the E/M code 99205; if all the above criteria are met.


Hope that helps.


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