Can a Psychologist Bill 99417 with 90837? A Complete Billing Guide

Introduction to Can a Psychologist Bill 99417 with 90837?

Quick answer – yes, a psychologist can bill 99417 with 90837, but there’s some important stuff we need to cover.

Understanding These CPT Codes and Why They Matter

When I first started my psychology practice, billing codes felt like a foreign language. But here’s what you need to know:

90837 represents your standard 60-minute psychotherapy session. Think of it as your baseline code.

99417 is the add-on code for extended time. Each unit equals 15 minutes beyond your base session time.

The Financial Impact on Your Practice

Running multiple therapy practices taught me something crucial – proper billing can make or break your bottom line.

Most psychologists leave money on the table because they’re unsure if they can bill 99417 with 90837. The truth is, you absolutely can – when done correctly.

I’ve seen practices boost their revenue by 15-25% just by properly billing these extended sessions.

Getting Down to the Nitty-Gritty Rules

The million-dollar question remains: can a psychologist bill 99417 with 90837? Yes, but you need to follow these rules:

• Your session must go beyond the initial 60 minutes
• Each unit of 99417 requires a full 15 minutes
• You must document medical necessity
• The extra time needs clear justification
• Both codes must be submitted on the same claim

Documentation: Your Best Friend or Worst Enemy

Let’s talk documentation because it makes or breaks your ability to bill these codes together:

1. Start and end times (be exact)
2. Detailed interventions used
3. Clinical justification for extended time
4. Patient’s response to treatment
5. Plan for next session
6. Progress toward treatment goals

Real Numbers and Time Tracking

When billing 99417 with 90837, here’s how the time breaks down:

• First 60 minutes = 90837
• 75 minutes total = One unit of 99417
• 90 minutes total = Two units of 99417
• 105 minutes total = Three units of 99417

Insurance Verification Steps

Before you start billing 99417 with 90837, check these boxes:

1. Call the insurance provider
2. Verify coverage for both codes
3. Ask about any modifiers needed
4. Confirm documentation requirements
5. Get pre-authorization if required

Common Pitfalls to Avoid

I’ve seen plenty of practices mess this up. Here’s what not to do:

• Billing 99417 without meeting the full 15-minute threshold
• Missing proper documentation
• Forgetting to link both codes on the claim
• Not getting required pre-auths
• Using it for every session without proper justification

When Extended Sessions Make Sense

You’re probably wondering when it’s appropriate to use both codes. Here’s my experience:

• Crisis intervention sessions
• Complex trauma processing
• Family sessions with multiple members
• Intensive treatment planning
• Initial diagnostic evaluations
• Complex case coordination

The Money Side of Things

Let’s talk cash – because that matters:

• Standard 90837 reimbursement varies by insurance
• Each unit of 99417 typically adds £20-40
• Some insurers have caps on total units
• Private pay rates should reflect the extended time

Setting Up Your Practice for Success

To successfully bill 99417 with 90837, set up these systems:

1. Clear scheduling blocks
2. EHR templates for extended sessions
3. Documentation checklists
4. Insurance verification processes
5. Patient notification systems

Risk Management Strategies

Protect your practice when billing these codes together:

• Keep detailed time logs
• Document medical necessity
• Create clear policies
• Train your staff
• Regular audit reviews

Patient Communication Tips

Be upfront with patients about extended sessions:

• Explain potential extra costs
• Discuss insurance coverage
• Set clear expectations
• Get informed consent
• Review benefits together

Future-Proofing Your Billing Practices

The billing landscape keeps changing. Stay ahead by:

1. Regular payer policy checks
2. Staff training updates
3. Documentation reviews
4. Billing pattern analysis
5. Coding updates monitoring

Remember, when asking “can a psychologist bill 99417 with 90837,” the answer is yes – but success lies in the details and proper execution of these billing practices.

Final Tips for Success

• Keep excellent records
• Stay updated on policy changes
• Build relationships with insurance reps
• Invest in good billing software
• Regular staff training
• Monitor claim patterns
• Review rejected claims carefully

The key to successfully billing 99417 with 90837 is understanding the rules, maintaining proper documentation, and staying current with insurance requirements.