Can Add On Therapy Be Just With the Patient's Family?

Can you bill an add on psychotherapy code like 90833, 90836, or 90838 if the appropriate number of minutes was spent talking to a parent alone? What about taking that time to speak to a grandma alone about how her interactions with her child were impacting the client's mental health? NOPE. Nope. Nope. While a prescriber can bill for family counseling, add on psychotherapy, by it's nature and definition requires that some of the time spent in that service is spent face to face with the client. A client's family CAN be present, but the client must be there as well, at least for SOME of the session. So...if you feel talking with family members is an important part of your client's mental health, either:

• Perform family counseling separately and you have the option to include or not include the client in thoses sessions, OR

• Include the client in at least some of the session and you can use an add on psychotherapy code.

Here is the source from the CMS website:

"Psychotherapy times are for face-to-face services with the patient. The patient must be present for all or some of the service. In reporting, choose the code closest to the actual time (i.e., 16-37 minutes for CPT codes 90832 and 90833, 38-52 minutes for CPT codes 90834 and 90836, and 53 or more minutes for CPT codes 90837 and 90838)."

Family psychotherapy codes are:

90846 (50minutes without the patient), or

90847 (50 minutes with the patient)

Source: https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57520&ver=29#:~:text=This%20service%20is%20used%20in,psychotherapy%20(CPT%20code%2090853).