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2012 Texas Medicaid Provider Procedures Manual

Behavioral Health, Rehabilitation, and Case Management Services Handbook : 6. Physician, Psychologist, and Licensed Psychological Associate (LPA) Providers : 6.11 Psychotherapy or Counseling : 6.11.6 Insight Oriented Behavior Modifying and Supportive Outpatient Psychotherapy or Counseling

6.11.6
Psychiatric diagnostic interviews, pharmacological regimen oversight, and pharmacological management will be denied as part of the following outpatient psychotherapy or counseling services when billed on the same date of service by the same provider in addition to the limitations detailed below by procedure code:
Procedure codes 36640, 90801, 90802, 90804, 90805, 90806, 90862, M0064, and any E/M service will be denied as part of procedure code 90807 (45 to 50 minutes)
Procedure codes 36640, 90801, 90802, 90804, 90805, 90806, 90807, 90808, 90862, M0064, and any E/M service will be denied as part of procedure code 90809 (75 to 80 minutes)
Procedure codes 36640, 90801, 90802, 90812, 90813, 90814, 90862, M0064, and any E/M service will be denied as part of procedure code 90815 (75 to 80 minutes)

Texas Medicaid & Healthcare Partnership
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