Billing Code 90833 with 99244
Yes, you can bill code 90833 (psychotherapy add-on code) with 99244 (consultation code) on the same day. 1
Understanding the Codes
- 99244: Consultation code for office or other outpatient visit
- 90833: Add-on code for 30-minute psychotherapy performed with an evaluation and management service
Billing Guidelines for Combined Services
Proper Use of Add-on Codes
- Code 90833 is specifically designed as an add-on code that can be used with evaluation and management services, including consultation codes like 99244 1
- The American Academy of Child and Adolescent Psychiatry confirms that the GT modifier "95" can be used with both 90833 and 99244 when these services are provided via telemedicine 1
Documentation Requirements
- When billing both codes together, ensure:
- Clear documentation of the medical necessity for both services
- Separate documentation for each component of service
- Proper time allocation for each service
- Medical decision-making is clearly documented 2
Modifier Usage
- No modifier is needed for the add-on code 90833 as it's designed to be used with E/M services
- If services are provided via telemedicine, use the appropriate telemedicine modifier (95) 1
Common Pitfalls to Avoid
Documentation Issues
- Insufficient documentation of medical necessity for both services
- Failure to document time spent on psychotherapy separately from the E/M service
- Not clearly distinguishing between the E/M component and psychotherapy component 2
Billing Errors
- Attempting to bill psychotherapy as a standalone service (90832) instead of using the add-on code (90833)
- Incorrect time allocation between services
- Not meeting the minimum time requirements for the psychotherapy add-on code
Best Practices
- Document the medical necessity for both the consultation and psychotherapy services
- Clearly separate the documentation for the E/M portion and the psychotherapy portion
- Track and document time spent on each service component
- Ensure the psychotherapy portion meets the minimum time requirement for code 90833 (30 minutes)
- Review documentation before submission to ensure compliance with billing requirements 2
By following these guidelines, you can appropriately bill both 99244 and 90833 together for the same patient on the same day.