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Family psychotherapy codes 90847 – simple question I promise!

Hello all,

A provider sees siblings both patients of this provider at the same time/visit The visit entails the true definition of 90847. The provider provides individual face to face assessments then has the siblings join together to observe behavioral interaction. Can the provider bill 90847 for each sibling? I tried to find something out there in cyber space but could not find a resourceful answer. Any help would be appreciated. Thank you! :confused:

Definition of 90847

The therapist provides 50 minutes (Excludes Service times of less than 26 minutes) of family psychotherapy in a setting where the care provider meets with the patient and the patient’s family jointly. The family is part of the patient evaluation and treatment process. Family dynamics as they relate to the patient’s mental status and behavior are a main focus of the sessions. Attention is also given to the impact the patient’s condition has on the family, with therapy aimed at improving the interaction between the patient and family members. Reviewing records, communicating with other providers, observing and interpreting patterns of behavior and communication between the patient and family members, and decision making regarding treatment, including medication management or any physical exam related to the medication, is included.
• 90846 – Family psychotherapy WITHOUT patient present, 50 minutes
• 90847 – Family psychotherapy (conjoint) WITH patient present, 50 minutes

Medical Billing and Coding Forum

90847 Family Psychotherapy–Need clarification

The facility that I do billing for has a particular psychiatrist who bills 90847 quite frequently.

I mostly see this when the patient is a minor and the mother/father is present during the visit who help provide history, medication or behavioral updates (example: "Mother reports increased irritability), etc. The psychiatrist also lists a review of systems, a mental status exam, history and plan in her notes.

To me, it would seem more appropriate to bill an E&M code rather than 90847 only. Thoughts? I’m getting really frustrated with this as not a lot of insurances will cover 90847/46. When I think of psychotherapy, I was told this is more "talk therapy" where the psychiatrist discusses coping mechanisms etc.

Note: These visits are done in a partial hospitalization setting

Medical Billing and Coding Forum

Family meeting without medicare patient present

I’m sure the answer is no, but a provider is wanting to charge for a service where she spent 45 minutes with the family without the patient present. She talked about the family being able to manage her care vs end of life decisions. Can code 99487chronic care management be used? If not, is there any code that can be used and paid by Medicare? My colleagues and I feel there is not. Thanks

Medical Billing and Coding Forum

90846 family psychotherapy without pt present

Does anybody know the guidelines for cpt 90846 family psychotherapy without patient present? Does the patient still have to come in, get vitals, etc to be able to bill the insurance or can just the parents come in? I know Medicare requires a face-to-face visit to be able to bill them but I’m unsure with this code.
thanks

Medical Billing and Coding Forum

New Physician with a new specialty in a family pratice

We are a family practice clinic with a DO and FNP. We recently had an internist join our practice. When she sees patients who are already established with the practice but will be seeing her as their new PCP can we bill that visit as a new patient visit since she has a different specialty? Or is primary care – primary care?

Medical Billing and Coding | AAPC Forum