Billing and Coding: Psychiatry and Psychology Services

Medicare covers psychiatry and psychology services when medically necessary, including when discontinuation would likely cause deterioration, and allows CORF social/psychological services by qualified social workers or psychologists. Specific CPT codes have provider, time, and frequency restrictions (e.g., diagnostic procedures once per day, time-based psychotherapy code mapping, and several codes not covered or physician-restricted), and claims must include valid ICD-10 codes, required referrer information, and documentation of medical necessity while observing HIPAA protections for psychotherapy notes.

"Psychiatric/psychological services are covered when there is a reasonable expectation that withdrawing treatment would cause the patient's condition to deteriorate, relapse, or require hospitalizat..."

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