Psychiatric Claims – Multiple Claims for Same Patient/Same Day

In accordance with the preamble to the psychiatry visit page, there is a prohibition against claiming more than one service for the same patient on the same day by the same psychiatrist in only the following two circumstances:

  • Individual psychotherapy and psychiatric care cannot be claimed for the same patient on the same day.
  • Individual or group psychotherapy cannot be claimed for the same patient on the same day as ECT.

In other cases, and subject to the Rules of Application in the Physician’s Manual, there is no prohibition against a psychiatrist claiming more than one service listed on the psychiatry visit pages for the same patient on the same day.

For example, a psychiatrist could perform a Complete History and Psychiatric Examination – adult (tariff 8503) and subsequently provide Psychiatric Care (tariff 8584) to the same patient on the same day. These would both be paid.

Psychiatrists are encouraged to carefully review their remittance statements to ensure claims are paid appropriately.

Questions?

Roger Jamieson
rjamieson@docsmb.org
(204) 985-5849

Updated: December 2016