Additional codes that may be useful for child and adolescent psychiatrists are listed below. However, having an established RVU does not guarantee reimbursement by insurance carriers. The physician must check with each carrier to establish reimbursement policies. If the service is listed as non-covered under the plan, the patient may be billed directly.
| Table 3. Other Psychiatric Services | |
|---|---|
| Code | Service |
| 90865 | Narcosynthesis |
| 90867 | Therapeutic repetitive transcranial magnetic stimulation (TMS); initial |
| 90868 | Therapeutic repetitive transcranial magnetic stimulation (TMS); subsequent |
| 90869 | Therapeutic repetitive transcranial magnetic stimulation (TMS); subsequent motor threshold re-determination with delivery and management |
| 90870 | Electroconvulsive therapy (ECT) |
| 90875 | Individual psychophysiological therapy incorporating biofeedback training, 30 minutes |
| 90876 | Individual psychophysiological therapy incorporating biofeedback, 45 minutes |
| 90880 | Hypnotherapy |
| 90882 | Environmental manipulation |
| 90885 | Psychiatric evaluation of records |
| 90887 | Interpretation or explanation to family |
| 90889 | Preparation of psychiatric report |
| 90899 | Unlisted psychiatric service or procedure |
| 90901 | Biofeedback training by any modality |
| 90911 | Biofeedback training, including EMG and/or manometry |
CPT Code 90887
Interpretation or Explanation of Results of Psychiatric, Other Medical Examinations and Procedures, or Other Accumulated Data to Family or Other Responsible Persons, or Advising Them How to Assist Patient
Medicare will not reimburse for this service because it is not done face-to-face with the patient, and clinicians should verify coverage by other insurers to ensure reimbursement. It is appropriate to use an E/M code in the hospital where floor time is expressed in coordination of care with the time documented.
CPT Code 90885
CPT code 90885 is used when a provider is asked to do a review of records for psychiatric evaluation without direct patient contact. This may be accomplished at the request of an agency or peer review organization. It may also be employed as part of an overall evaluation of a patient’s psychiatric illness or suspected psychiatric illness, to aid in the diagnosis and/or treatment plan.
Documentation Tips
Documentations to clearly identify, as well as the providers interpretation of the data evaluation. All entries to the medical records should be dated and authentica
Reimbursement Tips
Check with the specific payer to determine coverage. Very few third-party payers provide coverage of this service. In the case of reports provided at an agencies or employers request, a fee should be discussed in payment arrangement made prior to the rendering of the service.
BCBS Non Covered: Procedure/service not covered by BCBSOK. Not subject to utilization review.