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95 Modifier for Telehealth Billing [2020]

CMS 1500 95 Modifier Claim

The 95 modifier is a new coding modifier used for claims. It was introduced in 2017 and is different from CPT or procedure codes, and describes the claim. One example of a modifier that has been used for many years is the HJ modifier which is used to code EAP claims. 95 Modifier Description The […]

GT Modifier for Telehealth Billing [2020 Guide]

CMS 1500 GT Modifier

The GT modifier is a coding modifier used for Telehealth claims. For many years it was the standard for signifying Telehealth claims before being mainly supplanted by the 95 modifier. In 2018, when CMS and Medicare stopped using this mainly companies followed suit and switched to 95 modifier. Despite this, there are still some insurance […]

HJ Modifier for EAP Billing and Coding [2020 Guide]

HJ Modifier on CMS 1500 Claim

The HJ billing modifier is a H Code HCPCS modifier used in coding claims. This H group of modifiers are used to describe either something about the claim or the credentials of the provider. The HJ modifier is the most commonly used of the HCPCS modifiers in behavioral health claims. HJ Modifier Description The HJ […]

HP Modifier: Clinical Psychologist Billing Guide

Billing HP Modifier on CMS 1500 Claim

The HP modifier, like the HO modifier and HN, is a HCPCS modifier used in coding claims. This group of modifiers are used to describe something else about the claim. One more commonly used example is the HJ modifier which is usually used to code Employee Assistance Program (EAP) visits. Insurance companies will request that […]

CPT Code 99355: The Definitive Guide [+Reimbursement Rates]

CMS 1500 with CPT Code 99355

CPT Code 99355 is a prolonged service CPT code add-on.  99355 cannot be billed alone and must be billed with an appropriate procedure code as well as another prolonged service code, 99354. Add-on Code 99355 fits into a sub-group of add-ons from 99354-99359 of prolonged services codes.  Up until recently, only medical doctors could bill […]

Family Therapy Billing CPT Codes: The Definitive Guide

CMS 1500 90847 Claim

CPT Code 90847 is a procedure code for behavioral health claims. 90847 is defined as Family psychotherapy (conjoint therapy) (with the patient present), 50 minutes.. Along with 90846 it falls into a subgroup of family psychotherapy procedure codes. It’s billed by Licensed Clinical Social Workers (LCSW), Licensed Professional Counselors (LPC), Licensed Marriage Family Therapist (LMFT), […]

CPT Code 90846: The Definitive Guide [+Reimbursement Rates]

90846 on CMS 1500 Claim

CPT Code 90846 is a procedure code for licensed behavioral health providers.    90846 is defined as Family psychotherapy (without the patient present), 50 minutes. Along with 90847 it falls into a subgroup of family psychotherapy procedure codes. The procedure code is frequently billed by Licensed Clinical Social Workers (LCSW), Licensed Professional Counselors (LPC), Licensed […]

CPT Code 90404: The Definitive Guide [+Reimbursement Rates]

99404 CMS 1500 Claim

CPT Code 90404 is an oddity in the collection of regularly billed CPT codes.  Cigna created this procedure code to describe EAP sessions taking place through their billing system. CPT Code 90404 Description 90404 is defined as Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual. This isn’t the most descriptive CPT […]