Update on 59 Modifier

Barbara Griswold researched and wrote an article about the new CPT code changes for mental health effective January 1, 2017 and graciously allowed us to reprint her article which you can read here.

Since then a kind reader sent us more information on her experience with using the 59 modifier.  She states that they have had good experience getting paid using the modifier XE in place of the 59 modifier when billing the CPT code 90847 along with 90832, 90833, 90834, 90836, and 90837 and 90838.

I checked back with Barbara and she researched further and sent me the following information.

The 59 hasn’t been deleted but I found that some codes that have come out that should be used instead since they are more specific, most notably XE in the case we are talking about when a therapist does a couples and individual session in the same day.  I’m not sure if this is just Medicare, or if private plans will accept this,  but a few websites seemed to verify this.  Here is one of them that explains it well.

Thanks for clarification Barbara

Author of Navigating the Insurance Maze: The Therapist’s Complete Guide to Working with Insurance — And Whether You Should” www.theinsurancemaze.com