MD and LCSW/Psychologist and split RVU

[DD214_DOC]

Someone told me about the following and I wanted to confirm/refute. I tried to verify this information on my own but haven't had any luck.

In my clinic, many parents schedule their child to see me (the psychiatrist) and their therapist (LCSW, LPC, or psychologist) on the same day for convenience. I do my thing, use my E/M code (I don't do any therapy add-on codes for these), then the therapist does theirs and codes appropriately.

Someone informed me that, in such circumstances, the two providers actually end up SPLITTING the total RVU generated equally between them. I have no idea where they got this from, but I have heard it from a couple other docs. Is this true? If so, reference?

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[smalltownpsych]

That's not how we do it here. It doesn't seem to make much sense. Each specialty does their own thing and bills for it. Think of a patient who comes in for some type of physical complaint. They might see cardio, gastro, radio, and IM all in the same visit and each would code and bill for their services. Why would this be any different? The only time it can be a problem is if the same procedure is being billed at the same visit. Some insurances won't pay for that. So if we both used psychotherapy codes then they might only pay one. Actually what insurances do is refuse the whole claim at first in hopes that you don't fix it and resubmit before they age it out and refuse to pay anything. Of course, didn't CMS come up with this whole RVU thing so maybe it really doesn't make sense.

 

[hamstergang]

Split by whom?

 

[Jules A]

The only time I heard of this was when one of the psychiatrists who didn't stay their lane added therapy codes to their services and the actual therapists were then unable to bill on the same day.

 

[abcxyz0123]

.

 

[DD214_DOC]

Split by whom?

The mysterious powers that be in some far-off land nobody knows of. Maybe this is just a weird DoD thing? The RVU splitting stuff is being passed around as fact, but I can't actually find anything to verify it as true, or refute it as false.

 

[Shikima]

You wouldn't split. Just bill your normal E&M and the therapist will bill their own codes for the time and service rendered.

 

[DD214_DOC]

You wouldn't split. Just bill your normal E&M and the therapist will bill their own codes for the time and service rendered.

It seems goofy to me, but this is the rumor going around.

 

[Shikima]

It seems goofy to me, but this is the rumor going around.

Good 'ol scuttlebutt.

 

[DD214_DOC]

Good 'ol scuttlebutt.

It thrives here, especially in an office predominantly civilian women.