Mental Health 11 months and 3 weeks between visits

[NuBiker]

I  do billing for a psychologist. Most patients average six visits (one a week), and then they are gone, and case is closed.
I have a patient who was last here on 10-20-2010, then came back on 10-07-2011.
I did not bill this patient as 90801 - what I always bill a new patient, I billed 90806, as a continuing patient.
Should I have billed as a new patient? I cannot find my billing school book to look it up, but I thought 12 months had to pass between visits, or - they changed insurance companies before I could officially call them a new patient.
I am a frequent lurcker here - I appreciate everone's contributions to this site, and I will try to contribute more!!!

Best Regards,
NuBiker

[Michele]

There isn't a set time period.  It varies by carrier.  Some carriers state that a 90801 can be billed at the onset of a new illness.  Most providers use that I am familiar with use that, plus a time frame.  For example if the patient hasn't been in for a while and they are coming for a different reason than the previous counseling, they consider it a new case.  If they are returning for treatment for the same dx as previous treatment, they consider it continuing care.

[NuBiker]

Thank you for the reply. Yup - that have the same DX, so to me it is continuing treatment.

[PMRNC]

I  do billing for a psychologist. Most patients average six visits (one a week), and then they are gone, and case is closed.
I have a patient who was last here on 10-20-2010, then came back on 10-07-2011.
I did not bill this patient as 90801 - what I always bill a new patient, I billed 90806, as a continuing patient.
Should I have billed as a new patient? I cannot find my billing school book to look it up, but I thought 12 months had to pass between visits, or - they changed insurance companies before I could officially call them a new patient.
I am a frequent lurcker here - I appreciate everone's contributions to this site, and I will try to contribute more!!!

What did the provider's superbill or daysheet say? I require my provider's to have that done before I bill it. IMO if the patient is returning for same diagnosis it would NOT constitute a 90801 under that time elapsed.