It's no secret that therapists across the globe aim to help people sort out obstacles in life. In some cases, clients seek guidance on an individual basis and work with health professionals one-on-one for improvement. However, therapists often find it helpful to include significant others or family members when a crisis involves a relationship.
Therapists recommend couples and family sessions for resolving conflict, but billing for these services can be tricky, as meetings increase in duration. Couples and family therapy might be the best route for your client, and fortunately, getting reimbursed for your service is straightforward with new codes for claims.
Why Couples and Family Therapy?
All relationships and families are unique. The need for group sessions becomes more apparent as a single client prepares for large changes or simply requires better communication with loved ones. Depending on the circumstance, therapists might recommend couples or family therapy in the following scenarios:
- Client filing for divorce
- Client calling for help regarding mental/behavioral health
- Handling a death in the family
- Parent conflict
The overall goal of couples and family therapy is to provide an open platform for discussion. While improvement in a family system takes time, individuals learn more in these sessions about strengths and weaknesses within relationships and can better communicate feelings.
Therapists play a pivotal role in couples and family therapy, as health professionals guide discussion and session structure. In order to provide time for each person to voice their concerns, longer meetings (45–60+ minutes) are necessary for results. Longer therapy sessions allow for in-depth assessments for treatment, but correctly filing claims is key for proper reimbursement.
CPT Codes for Individual Therapy Sessions
Billing for family and couples therapy used to be an obstacle if a professional was regularly meeting with a single client. The American Medical Association (AMA) set codes 90832, 90834 and 90837 for individual therapy billing with an occasional guest visitor. Back in 2016, these guidelines controlled billing claims for infrequent visitors that did not require help but were involved in recovery for the Identified Patient.
As therapists reported increased session lengths, the AMA launched Prolonged Service codes 99354 and 99355 for professionals adding additional time to meetings. These codes make it easier to file billing claims for sessions exceeding 60 minutes at a time. In order for therapists to include Prolonged Service codes for billing, they must consider the following:
- Sessions must extend a minimum of 30 minutes from the original code for use of Prolonged Service extensions.
- Prolonged Service codes must be listed with the original session code for all claims.
What Is the Billing Code for Couples/Family Therapy Sessions?
When you're filing a claim for couples and family therapy service, remember that CPT code 90847 indicates that a group session took place on a given day. CPT codes for couples and family therapy should always include 90847 on billing claims and any documentation. The only time to stray from this billing code is if you find yourself meeting with the Identified Patient or a non-IP family member alone.
If meetings do not include entire groups, remember the following information:
- You should use codes 90832, 90834 or 90837 for the IP. Doing so follows the protocol for an individual therapy session without guests.
- The CPT code 90846 is for family and couples therapy without your IP present.
For proper reimbursement, always verify a client's insurance plan. Insurance companies tend to honor Prolonged Service codes as long as they're present on claims, invoices and bills.
Contact ICANotes for Billing Documentation Solutions
ICANotes can provide integrated mental health billing solutions for your practice. Our services will cater to your industry by automatically generating the highest possible reimbursement codes supported by your note. Contact ICANotes for more information about our behavioral health documentation solutions, and try our free trial today.
Clinical Director October has been a Registered Nurse for over 15 years. She is board certified in Mental Health and Psychiatric Nursing. She holds a Bachelor of Arts from the University of North Carolina at Greensboro. She also graduated with bachelor and master degrees in Nursing from Western Governors University.