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90791 –Help

How many times can 90791 be billed? I have read threads from 2014.. but I wanted to know if its been updated. We have LCSW working and I don’t know if they have a limit of billing it, because they are billing it more than often, per patient. I can find no information on CMS.. if anyone is familiar with this, any help would be appreciated. Thank you.

Medical Billing and Coding Forum

90791 Billing

Good afternoon, All,
I see where this question was posted once before, but I don’t see where anyone ever responded to it. We have now had this happen in our Pain Management practice and I’m not quite sure how we bill it. Here is the original question:

‘We have a pt that came in for an assessment but was not able to finish on this day she came back a couple days later to finish the assessment. Are we able to bill 90791 for both days or can we only bill one 90791 and if so does it matter which day we bill this on?"

Also, if you can’t bill 90791 for the return visit, what code do you bill?

Any input would be greatly appreciated.

Thank You!

Medical Billing and Coding Forum

90791 Question

Good afternoon, all.

We are a medical pain management practice and have hired a LCSW to enhance the services we render to our patients. We are wondering how many hours it should take our LCSW for a psych diagnostic eval (90791)? How many of these should she be reasonably expected to do in a week?

Any feedback or pearls of wisdom would be greatly appreciated.

Medical Billing and Coding Forum

Psychiatric eval 90791 and Psychological testing 96101

Our Psych providers are posing the below question.

90791 – Psychiatric diagnostic evaluation
Providers currently bill 90791 for an initial intake appointment. This is when the providers are gathering information from the parents regarding their concerns. Outside of the appointment, the parents complete questionnaires and measures to help the psychologists determine what diagnostic testing may be appropriate.

If testing is warranted, they then bill 96101 for the testing/evaluation and the subsequent time it takes to analyze, write the reports, etc. An authorization for this service is often required and they may request up to 8 hours for it.
96101 – Psychological testing (includes psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, eg, MMPI, Rorschach, WAIS), per hour of the psychologist’s or physician’s time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report

Our question is since the 90791 is broad, what would keep them from being able to bill 90791 for the testing and then 96101 for the time it takes to interpret the results and write the report?
Can anyone offer any insight??

Medical Billing and Coding Forum