Psychotherapy Basics
What is the minimum time requirement for add-on psychotherapy?
16 minutes
Is providing a patient with information about sleep hygiene considered add-on therapy?
No, providing a patient with information on sleep hygiene is generally not considered add-on psychotherapy. Basic education about sleep hygiene, nutrition, or exercise is typically part of routine care provided during an E/M visit (e.g., 99213, 99214) and does not qualify as psychotherapy.
What is an example of a Total Time that could be documented for 90833?
any number from 16-37 minutes
What are 3 examples of evidence-based therapies that can be integrated into add-on psychotherapy?
Cognitive behavioral therapy (CBT), interpersonal therapy, supportive therapy, solution-focused therapy, motivational interviewing and strategies from modalities like DBT
True or False. Third party payors generally reimburse Psychiatric Nurse Practitioners for psychotherapy billing codes
True
True or False-Details about the patient's interpersonal problems are required to be included in the medical record
False
You are struggling to concisely describe the interventions you used in your last session, what is a great option to reference when you're not sure which words to use?
Debbie's documentation guides/cheat sheets!
What is an example of a therapy modality that could be documented as add-on therapy?
CBT, MI, interpersonal, supportive, solution-focused
True or false: Couples counseling is a billable add-on psychotherapy service
False. Couples counseling is generally not a billable add-on psychotherapy service.
Is Psychotherapy recognized as within PMHNP scope of practice by the national certifying body for PMHNPs- American Nurses Credentialing Center (ANCC), which provides the PMHNP-BC (Board Certified) credential after passing the required examination
Yes
What percentage of change is attributed to therapy technique?
Therapeutic technique accounts for only 15% of the change process. The majority of change (60%) comes from extra-therapeutic factors and the therapeutic alliance (30%).
True or False-When billing for add-on psychotherapy, you must also use time-based billing for your E/M code (99213, 99214)
False. When billing for add on psychotherapy, the E/M service is billed based on the complexity of the medical decision-making
What is an example of target symptoms for therapy?
Anxiety and insomnia that are IMPACTING FUNCTION
Fill in the blank: Supportive psychotherapy focuses on stabilization, coping skills, and may involve ____________.
addressing social determinants of health/case management interventions
True or False - Psych NPs should review their state's Nurse Practice Act and any specific regulations around the scope of practice for advanced practice registered nurses (APRNs).
True
When documenting interventions used: Include specific therapeutic interventions, such as cognitive restructuring, relaxation techniques, mindfulness training, skill-building etc and Patient Response: Document the patient’s response to the interventions, including insight gained, progress made, or difficulties encountered
Employer/Facility Policies may have limitations around services PMHNPs can provide
If working in a healthcare organization, Psych NPs should check their employer's policies and scope of practice guidelines. - The facility may have additional requirements or limitations around the psychotherapy services Psych NPs can provide.
What do insurance companies LOVE to see at the end of your add-on therapy note
Client GOALS and PLAN
Educate leadership on the Psych NP scope of practice:
- Gather evidence from state regulations, professional nursing organizations, and payer policies that demonstrate Psych NPs are qualified to provide psychotherapy. - Present this information to administrators, medical directors, and other key decision-makers to show the legal and professional standards that support Psych NP psychotherapy services.