90833 add-ons

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freaker

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For those in practice, have you had many patients come back to you and mention that they're paying double or some variation thereof with 90833 add-ons? I rarely hear about billing issues but figure I might if they're getting 2 bills.

I'm seeing patients for 30-minutes and am legitimately doing psychotherapy services. I feel a bit guilty at times billing for add-on codes, as I live in an area where folks often come from a long way to see me without much in terms of finances. That said, I'm going to have to get used to the idea, as I don't like churning patients and enjoy knowing them and providing therapy services.

It also feels a bit odd billing less for the patient with an intellectual disability where we're not necessarily doing much psychotherapy but a lot of counseling than with the higher functioning patient where therapy is involved for the same length appointment.

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If you do therapy, bill for it. Apparently it's medicate fraud if you overcode or UNDERcode. At least that's my understanding as a resident. And the fee is about the same for a 99213 as it is for a 90833 so I could see why they'd be paying "double."
 
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