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Two common questions in billing for therapists are how to bill for prolonged sessions and how to bill for paperwork or case management.
In 2023, changes have been made to the billing codes related to prolonged sessions. The CPT codes 99354 and 99355 were deleted, posing a challenge for therapists using them for trauma-related services. However, a solution has been found where two units of code 90834 can be reported for a 45-minute session, totaling 90 minutes. Source Cited here: www.socialworkers.org/Practic...
The code G2212 has been approved for use by clinical social workers and other therapists to extend their sessions. It can be billed in 15-minute increments and is used as a replacement for the previous combination of codes for billing 90-minute EMDR processing sessions.
Behavioral Health Integration (BHI) services have introduced several approved codes for use by clinical social workers. These codes include 99484, which covers care management services for behavioral health conditions, and G0323, which refers to care management services provided by clinical psychologists or clinical social workers.
Billing for BHI services requires meeting specific criteria, such as using certified EHR technology and documenting time spent per client.
Other relevant codes include G0511 for general care management in rural health clinics or federally qualified health centers and H0004 for behavioral health counseling and therapy, billed in 15-minute intervals.
It's crucial to ensure that the codes used are included in insurance contracts before attempting to use them for billing.
List of Codes:
99354 and 99355 (deleted)
90834
90839 and 90840 (for crisis sessions)
G2212
99484
G0323
G0511
H0004
TimeStamps:
00:00 Introduction
00:31 Prolonged Services and Billing
01:20 New Solution for 90-minute Sessions
02:11 Update on Code g2212
03:20 CMS Changes Aimed at Reducing Administrative Burdens
03:42 Behavioral Health Integration Services and Approved Codes
05:02 Billing for BHI and Chronic Care Management
05:31 Codes for Rural Health Clinics and Federally Qualified Health Centers
05:50 HCPCS Code h0004 for Behavioral Health Counseling and Therapy
07:02 Importance of Checking Insurance Contracts
07:30 Conclusion and Importance of Understanding Codes
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