group therapy

Will Medicare reimburse for group therapy? 90853

Group therapy, Active code Medicare

Group psychotherapy codes should be used only when the focus of treatment involves group psychotherapy. There should also be documentation of the patient's capacity to participate in and benefit from psychotherapy if psychotherapy is the chosen treatment.
Documentation must reflect that the psychotherapy was administered in a group setting with a trained group leader who is authorized by state statute to perform this service.
Progress notes may be submitted to document the services that have been provided. Notes should address the nature or topic of the group psychotherapy session, progress made or the lack thereof, and any changes made in the therapy toward the goals of the treatment plan.

group therapy

Do you have experience with billing for LCSW? This is a new arena for us. Where on the Medicare website have you found information. Can you recommend a specific book?

Lcsw

The social worker must meet criteria set out by CMS for participation. They then may bill as allowed by their State Scope of Practice Laws. If qualified the may bill following codes: Clinical social workers may bill for 90801, 90802, 90804, 90806,
90808, 90810, 90812, 90814, 90846, 90847, 90853 and 90857.
The psychotherapy codes without medical evaluation and management may be
used by psychiatrists, clinical psychologists, and clinical social workers.
The CPT codes that describe individual psychotherapy and medical evaluation and management are only payable to a psychiatrist.
Payable places of service for a clinical social worker are home (12), office (11), and outpatient department (22).

group therapy

Thank you so much for all the information thus far. Can we as billers for LCSWs populate the refering provider field with the LCSW themself, or does the refering provider have to be a physician?

Lcsw

The refering provider has to be a MD or Psychiatrist.