Author Topic: EMDR mental health billing with 2013 codes  (Read 4151 times)

vsplinter

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EMDR mental health billing with 2013 codes
« on: March 01, 2013, 02:26:10 PM »
My client spends hours with her clients doing EMDR therapy and I am not sure how to bill it.  Are there any suggestions????

PMRNC

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Re: EMDR mental health billing with 2013 codes
« Reply #1 on: March 01, 2013, 03:21:18 PM »
I have a client who does these as well.  BCBS wants 90834 if done w/in a psychotherapy session  and 90899 if STAND alone.   The other carriers I've billed want the 90837 (replaces 90808) and I have not seen a carrier reimburse over 60 min so don't mess with the unit codes as they won't pay it. To be safe I always call and verify benefits to find out how they want it billed.  I have a few carriers that also want authorizations now where they didn't before. ??    Reimbursements I've seen for the 90837 are below the old code used of 90808 again because they are not going to cover the 90 min :( 
Linda Walker
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Ryan

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Re: EMDR mental health billing with 2013 codes
« Reply #2 on: June 02, 2013, 02:26:03 PM »
Hi Linda,

I have a new client, MSW LICSW, who utilizes EMDR over a 1 hour and 30 minute session. How should this be coded and billed?

Would this be correct:

90837, psychotherapy, 60 min., and
+90785, interactive complexity add-on code

Reading your post, it sounds like carriers are not paying for the additional 30 mins?

I'll be calling the misc carriers that my client is contracted with and asking them specifically how they would like this billed, but I wanted to get your input as well.

Thank you!

Ryan

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Re: EMDR mental health billing with 2013 codes
« Reply #3 on: June 02, 2013, 08:08:38 PM »
Looks like 90785 would not be appropriate in this case. Still unsure of the correct way to bill for the additional 30 mins past the initial 90837, psychotherapy, 60 min.

PMRNC

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Re: EMDR mental health billing with 2013 codes
« Reply #4 on: June 02, 2013, 08:48:35 PM »
Yep, I have a client who does EMDR as well, NONE of the carriers are going to go over the reimbursement for a 90837. I was told by UBH we can try for the 2 units but they would most likely deny it as more than one session in a day. This has been one of the biggest problems for the one client I have doing it. I did an Appeal with Magellan just last week actually but I am not holding my breath.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Ryan

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Re: EMDR mental health billing with 2013 codes
« Reply #5 on: June 03, 2013, 12:10:18 AM »
Ok Linda. Thank you.