Billing and Coding: Psychological Services Coverage under the Incident to Provision for Physicians and Non-physicians

Medicare covers psychological services in CORFs and allows billing to Part B for services furnished by physicians and authorized non-physician practitioners, while hospital outpatient psychiatric services are billed to the Part A MAC. Individual psychotherapy codes must be used only when psychotherapy is the primary focus, psychotherapy codes should include E/M and pharmacologic management when provided in the same visit (do not bill CPT 90863 separately), and appropriate ABN modifiers (-GA, -GX, -GZ, -GY) and documentation (including valid ICD-10, provider NPI, signed records, and supervision notes for 'incident to' services) are required for claims.

"Psychological services are covered when furnished in Comprehensive Outpatient Rehabilitation Facilities (CORFs)."

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