Marilyn Posted Mon 11th of February, 2019 14:47:07 PM
When billing 90837/ 1 hr, and then the additional 30min. There isn't an add on code unless for the 1st full hour '99354 and 99354.30 min. Am I right? Is there a code to capture the 30min?
SuperCoder Answered Tue 12th of February, 2019 03:46:26 AM
In CPT 90837, the provider performs psychotherapy and treatment session typically lasts for a minimum of 53 minutes or more up to 60 minutes. Whereas, CPT 99354 can be used in conjunction with 90837 for psychotherapy service(s) (beyond the typical service time of the primary procedure) require direct patient contact beyond the usual service. List separately this code in addition to code for psychotherapy service for first hour. Because +99354 is an add–on code, payers will not reimburse you unless you report it with an appropriate primary code such as 90837.
In addition to the published specified time for a primary psychotherapy (90837), the provider spends additional time on that office or outpatient service. The service requires direct contact with a patient. Use 99354 code for the first 30 to 74 minutes of additional time. The time used to calculate prolonged time on a single date does not need to be continuous.
Hope this helps!