documenting start and end time for 99205 and 90833

[liquidshadow22]

for these codes - are you required to document start and end times for each session?

also for 99205- this does include time spent reviewing charts, documentation etc - correct?

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[splik]

for psychotherapy add ons (including 90833) medicare requires you EITHER document total time OR start/stop time, not both. Some commercial insurances require start/stop times. Depends on the plan.

E&M codes (including 99205) only require total time, not start/stop times. Some plans do require start/stop times for whole visit if you are using psychotherapy add on codes. For 99205 if billing on time, you can include time on non-face-to-face activities including reviewing charts (other charts from different specialty or clinic, not your own records or those of your practice), documentation, coordination of care (e.g. collateral). If you bill on time, then you cant use these codes with a psychotherapy add on.

Not sure if you were asking about this, but with the 2021 changes, it is very hard to bill 99205 on MDM and thus rare that you would be able to bill 99205 with a therapy add on. Patients basically have to need hospitalization, lots of record review and collateral with independent review of records, and/or prescribing lithium or clozapine to an acutely decompensated pt. But if you bill on time you can easily use 99205 if you spend 60mins on a new pt visit.

 

[clausewitz2]

for psychotherapy add ons (including 90833) medicare requires you EITHER document total time OR start/stop time, not both. Some commercial insurances require start/stop times. Depends on the plan.

E&M codes (including 99205) only require total time, not start/stop times. Some plans do require start/stop times for whole visit if you are using psychotherapy add on codes. For 99205 if billing on time, you can include time on non-face-to-face activities including reviewing charts (other charts from different specialty or clinic, not your own records or those of your practice), documentation, coordination of care (e.g. collateral). If you bill on time, then you can use these codes with a psychotherapy add on.

Not sure if you were asking about this, but with the 2021 changes, it is very hard to bill 99205 on MDM and thus rare that you would be able to bill 99205 with a therapy add on. Patients basically have to need hospitalization, lots of record review and collateral with independent review of records, and/or prescribing lithium or clozapine to an acutely decompensated pt. But if you bill on time you can easily use 99205 if you spend 60mins on a new pt visit.

Yeah in going on two years of private practice and I have billed 99305+90833 once. Guy had a stack of records after being hospitalized for his first manic episode, his wife presented with him to the appointment, and we started lithium a week after discharge while reducing his neuroleptic dosing because of really bad EPS. The appointment also took about 75 minutes and we did a lot of processing his understandably complicated feelings about being diagnosed with bipolar I in his early 30s having never really interacted with the mental health system before.

Definitely rare.