Paying two copays with a 90833?

[st2205]

I had heard that if you bill a 90833 on top of E&M that the patient will have two copays. I guess this would make sense considering it's technically a separate service, but I had never heard this before. Is this accurate or dependent on insurance company or is this perhaps just a regional thing? If so, how are you handling that with patients?

 

[daru1]

I may be naive in this because of not accepting a lot of different insurances, but isn't 90833 a 'plus' code? It seem that you can't bill 90833 without an E/M, which means technically it's only one visit anyway. If it were two separate visits like a E/M and a separate 90837, I could see the rationale for 2 separate copays, but good luck getting past Stark if you get sued...