Is it normal for 4 hours of psych tests to take 15.5 hours to interpret/develop treatment plan?

corsican

New member
Was billed for 4 hours of psych testing from when i went in and had the tests done (week one).

Was then billed 5 hours week two for interp, 3.5 hours week three for interp, and another 7 week 3 for interp (15.5 total).

Is this normal? It seems a bit high to me but I have no clue what goes on once I leave so I wanted to ask.

Here is my EOB and itemized bill.


Here is what I was told when I asked why I was billed across multiple dates even though I was only in the office on one day on 5/3.

"The 96137 is for each additional half hour, 7 x $150 = $1050.

The additional dates of 5/8 and 5/15 were for scoring the testing materials you completed while in our office. The dates are submitted to insurance as the day the scoring was completed. We have to report these dates accurately."
 
@corsican The way the AMA defines those office visit codes, is not the length of time you were treated but "entire time spent on the encounter" that can include waiting room time, charting, reporting. It means even if a few hours after you left, 2 doctors have an hour meeting about your study? Add an hour to the code value.

The short answer of "are they allowed to do this?" Is yes. They are.

Still have a talk with the billing and doctors office though if you feel like they're fudging the hours worked on your case
 
@resjudicata For sure, I see the CPT codes Im questioning have 5 or so categories that all get billed to them.

I was just wondering if it was unusual for 15.5 hours to get billed for days I was not in the office.
 

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