Billing

[CD101.9]

Have you ever billed for a visit where you only filled out a SS disability form, and only a few moments of psychotherapy took place (maybe I should say only a few comments took place)? I am going to be doing this. I am a psychiatrist that is new to private practice. Thanks.

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[Shikima]

I don't do disability evals. Sorry. And psychotherapy must be a minimum of 17 minutes to qualify for 90833.

 

[erg923]

"A few comments" is obviously not psychotherapy. Whatever the physician equivalent of H0031 is (mental health assess) sounds like it would be appropriate. I think 5 minutes is the threshold for using that. If it's less than 5 minutes, have a heart and just suck it up.

 

[Shikima]

"A few comments" is obviously not psychotherapy. Whatever the physician equivalent of H0031 is (mental health assess) sounds like it would be appropriate. I think 5 minutes is the threshold for using that. If it's less than 5 minutes, have a heart and just suck it up.

I don't believe there is a code for this.... I could be wrong, but I don't think so.

 

[erg923]

If its just a few minutes at most, the OP is basically doing a mental status exam, in my opionion. Not sure how that is coded/billed.

 

[CD101.9]

Thank you for the responses. This form is being sent to me directly from SS. You are right Erg. It is just one visit. I could suck it up without getting paid.

 

[Therapist4Chnge]

If the pt is someone you have seen regularly and you feel comfortable speaking to the topic at hand (of the paperwork), then taking the 5min to do the paperwork should probably just be done. If the paperwork is more involved, not clinically/treatment related and/or forensic in nature…then I have a fee schedule for all of that. I get countless requests from law firms for additional documentation (e.g. letters to respond to new/diff questions), which takes far more time. I only provide consultation and assessment services, so YMMV w. traditional therapy patients.

One approach that many PP clinicians takes is scheduling a F/U appt to put eyes on the pt and fill out the necessary paperwork. During the time you can do a mental status exam, check in briefly about mood/meds/etc. and fill out the paperwork. I typically refuse to fill out any paperwork if I have not recently see the pt, as I do not want to inadvertently reporting incorrect information. It is really important to know what exactly they need, what it is for, and when it is due.

 

[vistaril]

Have you ever billed for a visit where you only filled out a SS disability form, and only a few moments of psychotherapy took place (maybe I should say only a few comments took place)? I am going to be doing this. I am a psychiatrist that is new to private practice. Thanks.

Just bill it as a 99213 or 99214 and document it as such

 

[TexasPhysician]

I'd charge a cash fee to do this.

 

[vistaril]

I'd charge a cash fee to do this.

Have you seen the form he is talking about though? If it's the one I'm thinking of, it takes all of 10 seconds and doesn't require you to really put any thought I to or or support/not support it. It's the type of thing a psych should really do out of professionalism in th context of a normal offic visit....

Now if it's not the 10 second form I'm thinking of and requires much more, them disregard the above.

 

[TexasPhysician]

Have you seen the form he is talking about though? If it's the one I'm thinking of, it takes all of 10 seconds and doesn't require you to really put any thought I to or or support/not support it. It's the type of thing a psych should really do out of professionalism in th context of a normal offic visit....

Now if it's not the 10 second form I'm thinking of and requires much more, them disregard the above.

Sure. If it takes less than 2 minutes, require a follow-up and involve counseling or whatever to bill a visit.

 

[vistaril]

Sure. If it takes less than 2 minutes, require a follow-up and involve counseling or whatever to bill a visit.

well presumably you are already going to have an established relationship with the patient anyways, so you are going to be seeing them as regularly scheduled(for a med mgt refill visit or whatever). I don't see any need to wonder/worry about need for f/u or any of the documentation we do already in a typical visit- I would never take on a new pt just for the point of filling out a disability eval so these concerns wouldn't be relevant.

 

[TexasPhysician]

well presumably you are already going to have an established relationship with the patient anyways, so you are going to be seeing them as regularly scheduled(for a med mgt refill visit or whatever). I don't see any need to wonder/worry about need for f/u or any of the documentation we do already in a typical visit- I would never take on a new pt just for the point of filling out a disability eval so these concerns wouldn't be relevant.

I think you misunderstood. I was agreeing with you. I just meant that I require a FU in which I complete the paperwork during that slotted time.

 

[CD101.9]

It is a long questionnaire which would probably take about an hour long to complete. All of the individual's mental health providers present and recent past will be expected to fill this rather long form out. SS then makes a decision after reviewing all these forms including information gathered from an evaluating psychologist that my patient has seen.