This guide will teach you how to bill for multiple mental health services on the same date of service using the correct same day modifier.
Mental health providers regularly perform an intake session and then see the client with their family, in group, or for another session on the same day.
These claims are often denied by insurance for missing the appropriate same day modifier and correct coding practices.
Let’s learn how to use same day modifiers so practice gets paid twice.
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Use Modifier 59
Same day modifier “59” describes services rendered for a different session or procedure on the same day. Often times this refers to different surgeries, body parts, or physical treatments.
In the context of mental health, however, it simply describes a different session of treatment and nothing more. These treatments occur sequentially.
This is a general modifier and some insurance companies may request more specific information.
New Modifiers XE & XP
These new modifiers created by Medicare offer further specificity in your coding. Call each insurance company to make sure these new codes are being accepted.
- XE – Separate Encounter. A service that is distinct because it occurred during a separate encounter on the same day.
- XP – Separate Practitioner. A service that is distinct because it was performed by a different practitioner.
When the intake took place and then the group therapy was also with the same provider, simply use modifier XE on the second CPT code.
If the second session is provided by a different provider, then use XP on the second date of service.
When the group therapy came after the intake and was with a different provider, use modifier XP.
Don’t Know What To Use?
Call the insurance company to ask, or work our mental health billing service to handle multiple mental health claims billed in the same day among other unique billing situations.