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POLL: Insurance billing and session length (US clients)

This poll is for clients in the US. I am curious about how your Ts/Ps bill for your therapy, particularly since Jan.2013 when new insurance billing codes were put into place.

Therapists are currently allowed to bill insurance for individual sessions in time increments of 30 minutes, 45 minutes, or 60 minutes. Since sessions do not always end exactly at those times, therapists are instructed to apply the following ranges:

90832 Psychotherapy, 30 minutes (from 16 to 37 minutes) with patient and/or family member

90834 Psychotherapy, 45 (from 38 to 52 minutes) minutes with patient and/or family member

90837 Psychotherapy, 60 minutes (from 53 minutes or longer) with patient and/or family member

"Psychologists who conduct sessions that require more than 60 minutes may continue to do so and will bill using the new 90837 code effective Jan. 1." according to The APA Practice Organization. In other words, if your session is longer than 60 minutes you should only be billed 60 minutes unless there is some add-on code (like a suicidal crisis) that can be used to justify additional charges.

The reason this is of interest to me is because at my first session with a new female P last week, I was asked to sign a paper that agreed that my sessions would last from 45-50 minutes long, and yet when questioned about the charges, the receptionist admitted that it was billed as a 60-minute session. I challenged the P on this when she also said my sessions would be around 50 minutes, sometimes longer and sometimes shorter. I said, I don't think I should be billed for 60-minute sessions if I am only getting 45 minutes of time. She seemed surprised that I knew about the insurance codes and (in my opinion) caught off guard. She admitted that my sessions needed to be 53 minutes to qualify for a 60-minute charge and then changed her story that my sessions would probably be 55 minutes long, despite the form I had to sign that said otherwise. Is this not financial exploitation of the client for the therapists benefit totally unethical and dishonest? I do not think I can or should trust a therapist who is dishonest in business, particularly when it benefits her at the client's expense.

So my first question is, were you aware of the changes in billing codes?

Second question is, do you know if your T/P bills for the appropriate amount of time spent with you, regardless of whether you have insurance?

This survey was originally posted to a topic here.
Posted by mad hatter ·
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