Need modifier code for mental health services rendered on an
outpatient basis  when an indiviudal session (90806) and group therapy
(90853) conducted on the same date -- example  3-26-04  90806 (need
modifier code)
                      3-26-04  90853 (need modifier code)

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Request for Question Clarification by sublime1-ga on 29 Mar 2004 22:27 PST

la2007...

In this pdf file from the Magellan Health Services site
("Magellan Behavioral Health is the nation?s leading managed
behavioral health and wellness company."), there are no
modifier codes listed in conjunction with indiviudal sessions
(90806) or group therapy (90853), under the column titled
'New HIPAA Compliant CPT, HCPCS or Modifier Code', though
there *are* modifier codes listed for other services, as 
you can see:
https://www.magellanprovider.com/ getpaid/HIPAA/advocare_cpt.pdf

What makes you think that a modifier code is required? If you
believe this resolves your concern, let me know, and I'll post
a formal answer.

sublime1-ga

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Request for Question Clarification by sublime1-ga on 29 Mar 2004 22:29 PST

Sorry, that link should be:
https://www.magellanprovider.com/getpaid/HIPAA/advocare_cpt.pdf

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Clarification of Question by la2007-ga on 29 Mar 2004 23:15 PST

For 
sublime1-ga


The modifier code is needed for billing for a Medicare claim. 
Medicare will not allow me to bill for an individual session (90806)
and group therapy (90853) on the same date without a modifier code
relected on form HCFA 1500.  Thank you.

la2007...

I couldn't find anything specific to this situation.
Perhaps another researcher will have a better outcome.

sublime1-ga