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Psychotherapy Billing Changes Coming July 1
From:
Sent:
To:
Passport Health Plan
June 1, 2015
Passport CMHC Providers
Background:
Effective July 1, 2015, the following coding must be used when billing claims to be compliant with the
National Correct Coding Initiative (NCCI).
Historically, Code 90837 (Psychotherapy) was billed in multiple units to indicate that multiple hours of
individual psychotherapy had been provided on the same day. Based on clarification from the
Kentucky Department of Medicaid Services, Code 90837 is now used for the first hour of individual
psychotherapy. Code 99354 is used to reflect individual therapy services that have exceeded 90
minutes and up to two hours in the same day. Code 99355 is used for each additional 30 minutes
beyond two hours and up to three hours in the same day.
Codes 90846 and 90847 (Family Psychotherapy) are event codes and may only be billed once per day.
These codes are not affiliated with a time limit.
Code 90853 (Group Psychotherapy) and Code 90887 (Collateral Therapy)are also event codes and may
only be billed once per day. These codes are not affiliated with a time limit.
Provider Action Needed:
To be compliant, please submit all claims with these directives.
Please refer to the Claims section (slides 73-78) of the Behavioral Health Overview presentation located
on Passport’s website for information on submitting and correcting claims.
Thank you for your assistance in helping us to comply with the new directives regarding these billing
codes.
Questions:
If you have any questions, please contact your Behavioral Health provider specialist or e-mail us at
[email protected] .
©2015 Passport Health Plan (PROV51413)