Can I get paid to sign the home health certification form?

CMS pays a small fee for the planning, certification, supervision and re-certification of home health services.  Don’t do the work and forget to get paid. Click the link below to watch this brief video about getting paid to sign the home health certification form.

Can I get paid to sign the home health certification form

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Keeping up to date, keeping costs low

Have you watched the two videos in this series? One was from 10,000 feet, explaining how codes and reimbursement rules result in payment.

The second was in the weeds—or rather, in the exam room—describing specific rules for selecting an E/M service based on time.

Watch the third video in this series now

Keeping up to date, keeping costs low

My new on-line, members only library provides up-to-date coding intelligence that respects your time and money.

At, you can

  • Educate new staff members, physicians, PAs, and NPs
  • Quickly search for a specific topic
  • Watch, listen, read or download—whichever you prefer

I’ve spoken to more than 17,100 medical professionals over the years. Physicians and coders tell me that I simplify complex coding concepts and explain them from their perspective, not coding-speak.  I wish I could come and visit all of your practices.  But, the next best thing is for you to watch the videos, listen to the podcasts, read the articles and download the billing guides I’ve put together at

If you join by midnight, December 14, 2016, you’ll receive 20% off the price of membership. As a bonus, you’ll be automatically signed up for my January 24, 2017 webinar: “New revenue opportunities for primary care in 2017.” You’re guarantee a spot for that webinar, which is sure to sell out.

Use this link to join at 20% off the regular price

P.S. If you missed the first two videos, you can watch them here and here, and download the supplemental resources here and here.

Please leave a comment below.


Crying in the exam-can I bill a higher CPT code?

A pediatrician described this situation to me. “I’m in the exam room with a teenage girl, and she’s crying. Lots of times, the mom is in the room too, and she’s crying.  Sometimes, the dad is in the room too, and he’s crying.  Can I bill a level higher if everyone in the room is crying?”

Well, we hope the doctor isn’t crying too, but who could blame him?

Watch this video about using time to select an E/M service and download the “Definitive guide to using and documenting time.”

Crying in the exam-can I bill a higher level of service?

Please leave a comment or question below.


More about, my new on-line membership library of videos, articles and resources coming soon.


Psychotherapy coding changes 2017

There were two changes in the psychiatry section of CPT for 2017. The first is the description of psychotherapy codes were revised to remove the words “and/or family.”   In 2016, CPT code 90832 was defined as “Psychotherapy, 30 minutes with patient and/or family member.” In 2017 the definition is “Psychotherapy, 30 minutes with patient.”   Codes 90833, 90834, 90836, 90837, 90838, and 90839 were similarly revised.

The CPT Changes Insider’s View 2017 notes that although another person may be in the room (and they label this person as an “informant”) the individual psychotherapy codes are for individual treatment and the patient must be in the room “for all or a majority of the service.” The therapy focus is on the individual, not the family, even if the family member is present for part of the session and provides information. Therapy focused on the family should be reported with family therapy codes. According to CPT, individual and family therapy may be reported on the same day, although your payer may not follow that coding rule.

Family psychotherapy now has time added to the description.

CPT code 90846 was revised from “Family psychotherapy (without the patient present),” to “Family psychotherapy (without the patient present), 50 minutes.”

CPT code 90847 was revised from “Family psychotherapy (conjoint therapy) (with the patient present),” to “Family psychotherapy (conjoint therapy) (with the patient present), 50 minutes.”

Psychotherapy codes follow the CPT time rule, which is that in order to bill the service, the clinician must meet the mid point of time. In this case, in order to bill either 90846 or 90847, the family therapy must be at least 26 minutes. As always, document time in the medical record when time is a descriptor.

CPT is making a clearer distinction between individual and family therapy.

Additional coding information is at

January 24, 2017 I am giving a webinar “New revenue opportunities for primary care in 2017.” Check back: I’ll post an announcement about registering in late December.