Most Psychiatrists have taken a drastic payment cut due to the deleted and new codes that were put into place at the start of 2013. Provider population surveys show that most psychiatrists are billing for the initial psychiatric evaluation with code 90792 for all facility types.
At Medical Billing Solutions, Inc., we strive to increase the reimbursements of our clients and have listed typical Medicare rates below so you can see the comparisons between billing for a 90792 and New Patient E/M Codes with Psychotherapy Add On Codes.
New Patients
- 90792 $123.65 (your facility)
- 90792 $120.55 (outside facility)
Hospital
- 99221 $98.87
- 99222 $133.75
- 99223 $196.16
Office
- 99202 $71.63
- 99203 $104.78
- 99204 $160.55
- 99205 $198.99
Psych Add On Codes for MDs:
- 90833 $41.35 (16-37 Min)
- 90836 $67.06 (38-52 Min)
- 90838 $108.34 (53+ Min)
Now here’s where the combinations come in to place
Inpatient Admit:
If you bill a 90792 for a new patient in the hospital, you would get $120.55, but if you would bill for a 99222 or 99223, then you would be making an additional $13.20-$75.61. I did not add on a psychotherapy add on code, since normally an inpatient admit does not involve psychotherapy on the first time being seen. But if you did perform psychotherapy, then your reimbursement would increase anywhere from an additional $41.35 – $108.34 depending on how much time was spent with the patient performing psychotherapy.
Office New Patient:
If you bill a 90792 for a new patient in the office, you would get $123.65. But if you would bill for any of the following combinations, then you would increase your reimbursements as follows:
- 99203 + 90833 (30 min psychotherapy) = $146.13 which is $22.48 more than billing a 90792
- 99204 + 90833 (30 min psychotherapy) = $201.90 which is $78.25 more than billing a 90792
If you were to replace your 90833 with a 90836, if you performed 45 minutes of psychotherapy instead of 30 minutes, then you would get an additional $25.71 in addition to the two amounts listed above for office new patients. Also, please note and remember that the psychotherapy add on codes go by time based rules, so even though 90833 reads as 30 minutes psychotherapy, it means time spent doing psychotherapy between the ranges of (16 -37 Min). The time ranges are listed above next to the fees.
Our mission at Medical Billing Solutions, Inc. is to maximize our client’s reimbursements while maintaining quality, affordability and integrity. We encourage all medical practices to regularly audit their charts and to code their services based on proper documentation and medical necessity of treatment. We are committed to achieving and maintaining the complete satisfaction of our clients in every way. We would be happy to assist your practice by providing a complete Medical Record Audit. Visit https://medicalbilling4u.com today for more information.