Billing with Modifiers

Dennis Given, Psy.D.

Licensed psychologist & owner of Psychology Associates of Chester County, Inc.

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2 Responses

  1. Barbara Kraft says:

    I bill for an FQHC where we have Medical OV’s and BH Tele-psych and counseling. I have issues when billing Med OV (99212-99215) on one claim and 9921x GT on another. I have come across modifier XP. Can you please give me more information on the modifier usage? Are there certain codes that this modifier can be used on? I’m assuming, even though these go out on different claims for same DOS, that I would only attach the modifier to one of the 9921x’s. Thank you for any help you can provide.

    • I’m not familiar with the particular codes that you mention since psychologists aren’t able to bill E/M codes. However, generally speaking you would add the modifier to one of the two codes for the same date of service. You may want to consult with your payer guidelines for more specifics on the use of modifier XP (or any other modifiers) with the insurance you are billing. Also, be sure that you aren’t billing a E/M code for a non-physician (behavioral health professional other than a psychiatrist) since it will likely deny due to the provider type. I don’t know if the rules about E/M codes are different in a FQHC so please let me know if I am mistaken.

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