Coding for 90 min. or 120 min. individual psychotherapy

Hello,

I have been going around with Blue Cross about this for months and would greatly appreciate any help. My son is going for individual therapy, which requires 90 minute or 120 min. sessions. His providers have been unable to locate a code for this and Blue Cross had given me a code to use, which is a generic code for medical services not for psychological services so that is not workable. Does anyone know of codes for 90 or 120 min. psychotherapy sessions? Thanks so much.

re: Coding for 90 min. or 120 min. individual psychotherapy

a lot depends on the specific BCBS coverage you and your son have, as well as the state in which you have the coverage.
Next to know is exactly what provider is providing the individual therapy: is it part of the psychiatric & med-follow-up session? or a session with a PhD/psychologist? or mental health therapies with an LCSW orLCPC? . . . as there are therapy-specific codes, and there are specifiers toward how an MD.PhD (vs PhD, LCSW, LCPC) may code. If you are referring to the 99212-99215 codes, yes, those E&M codes are completed by a psychiatrist, and they would also indicate in their note that counseling or psychotherapy occurred during the session. Otherwise, in the case of the other types of providers named, specific psychotherapy codes are needed. Even then, depending on the state and the policy, as 90 or 120 minute-long session may NOT be covered. Scenic route to in imprecise answer, I know. I'm happy to defer to someone out there who feels they can better answer this question.

re: Coding for 90 min. or 120 min. individual psychotherapy

Are there any other services being provided along with the individual session???? Need a little more info. But this is should get you started. Who is providing the services etc. 90 -120 mintues may not be covered, it is not standard session time.

These psychotherapy services are considered face-to-face
services with the patient and/or family member, with the
patient present for some or all of the service. The specific
amount of time associated with these three code titles may
well differ from the actual amount of time you provided
psychotherapy. In general, you should select the code that
most closely matches the actual time you spent. The CPT
manual provides for flexibility by identifying time ranges
in the descriptions of the three codes, as follows:
90832: 16 to 37 minutes
90834: 38 to 52 minutes
90837: 53 minutes or longer