Medicare

[rdmoore2003]

Does anyone have information or a link to Medicare in regards to hypnotherapy?

[rdmoore2003]

Merry,
Is this something new?  I show that they do cover,  I even have the allowed amount from Medicare.   I just want to see if the code is dx specific.

[HeidiK]

Hello!

I looked up hypnotherapy on cms.gov and found it is a covered service and following is the language from one of the LCD's I was able to pull.  The entire determination should be reviewed as it is state/carrier specific and may have been updated since 2009.

http://apps.ngsmedicare.com/lcd/LCD_L26895.htm

B. Description: Code 90880 is described as hypnotherapy. Hypnosis is an artificially induced alteration of consciousness in which the patient is in a state of increased suggestibility.

Documentation: Claims must be submitted with a covered diagnosis.

Comments: Hypnosis may be used for diagnostic or therapeutic purposes. Medicare will cover hypnotherapy for the following diagnoses:
300.11 Conversion disorder
300.12 Dissociative amnesia
300.13 Dissociative fugue
300.14 Dissociative identity disorder
300.15 Dissociative disorder or reaction, unspecified
300.21 Agoraphobia with panic disorder
300.22 Agoraphobia without mention of panic attacks
300.23 Social phobia
300.29 Other isolated or specific phobias
307.80 Psychogenic pain, site unspecified
308.3 Other acute reaction to stress
308.4 Mixed disorders as reaction to stress
308.9 Unspecified acute reaction to stress
309.0 Brief depressive reaction
309.1 Prolonged depressive reaction
309.21 Separation anxiety disorder
309.24 Adjustment disorder with anxiety
309.28 Adjustment disorder with mixed anxiety and depressed mood
309.3 Adjustment disorder with disturbance of conduct
309.4 Adjustment disorder with mixed disturbance of emotions and conduct
309.81 Posttraumatic stress disorder

Hope this gets you in the right direction!

[rdmoore2003]

thanks Heidi! 

[Merry]

Interesting feedback.  I just had a client get denied for submitting  claims for this.  Ok time to research more as it may have been a LCD or not the appropriate dx.  They were told it

wasnt a covered benefit.  Guess I should have checked the diagnosis
that was submitted. I removed my post where I said it wasn't covered.
Thx all

.time to research

[HeidiK]

Always be sure to check your specific state/carrier guidelines for exact coverage details!

[PMRNC]

Wow talk about learning something new..

I'm literally shocked they cover hypnotherapy.

[Michele]

My first thought was "Hypnotherapy isn't covered".  I was surprised too.

[rdmoore2003]

I knew that they covered with dx of ptsd.  Just wasnt sure on any other dx's.  thanks again Heidi.