Internal FAQ

The online provider billing sheet is the preferred way to submit completed services to Help Therapy. It allows you to enter the exact CPT codes and units supported by your documentation, including codes that may not have appeared in the previous dropdown menus.

Please enter one client and date of service per row and complete all applicable fields.

Important: The billing sheet extends across the page. Scroll to the right to view and complete all columns before submitting it.

How to Complete Each Row

Client Name

Enter the client’s full name as it appears in their patient record.

DOS

Enter the date of service for the encounter.

Place of Service

Enter where or how the service occurred. Examples include:

• Office

• Patient’s Home

• Hospital or Facility

• Telehealth

• Phone

Location of Service

Enter the specific service location:

• In person: Enter the complete address where the service occurred.

• Video appointment: Enter “Video.”

• Phone appointment: Enter “Phone.”

CPT Codes and Units

Enter each CPT code in a separate CPT Code field. Enter the number of units in the Units field immediately beside that code.

Most psychotherapy and medication-management codes are billed as 1 unit. Psychological testing codes may require multiple units based on the services performed and the documented time.

If you used more than four CPT codes, enter the remaining codes and units under Other CPT Codes & Units.

Example:

96131 – 2 units; 96137 – 4 units

Do not enter a code or unit unless the service was completed and supported by your documentation.

ICD-10 DX Code

Enter the ICD-10 diagnosis code that best supports the service provided.

Example:

F33.1

Copay Paid & Method

If a patient payment was collected, enter both the amount and payment method.

Examples:

• $25 – Credit Card

• $40 – Check

• $20 – Cash

• None Collected

Telehealth: Was the Patient at Home?

For telehealth services, select:

• Yes if the patient was physically located at home during the appointment.

• No if the patient was located somewhere other than their home.

This question refers to the patient’s physical location, not the provider’s location.

Common Psychotherapy Codes

Select the psychotherapy code according to the actual psychotherapy time documented, not the appointment’s scheduled length.

Psychotherapy Examples

Individual psychotherapy lasting 53 minutes or longer:

90837 – 1 unit

Family psychotherapy with the patient present:

90847 – 1 unit

Common Psychological Evaluation Codes

Psychological evaluations frequently require more than one CPT code. Evaluation, test administration, scoring, interpretation, treatment planning and report writing may be reported separately.

Evaluation, Interpretation and Report Writing

Code 96130 represents the first hour of psychological testing evaluation services. Code 96131 represents each additional hour.

Under Medicare’s daily Medically Unlikely Edit, the typical maximum is:

• 96130 – 1 unit

• 96131 – up to 7 units

Together, these codes can represent up to eight hours of psychological testing evaluation services on the same date of service when the time is medically necessary and fully documented.

Test Administration and Scoring by the Provider

Under Medicare’s daily Medically Unlikely Edit, the typical maximum is:

• 96136 – 1 unit

• 96137 – up to 11 units

Together, these codes can represent up to six hours of provider-administered testing and scoring on the same date of service when the time is medically necessary and fully documented.

Test Administration and Scoring by a Technician

Automated Testing

Psychological Evaluation Example

A provider completes:

• The first hour of evaluation and report-writing services

• Two additional hours of evaluation work

• The first 30 minutes of test administration and scoring

• Four additional 30-minute periods of testing and scoring

The billing sheet would show:

• 96130 – 1 unit

• 96131 – 2 units

• 96136 – 1 unit

• 96137 – 4 units

If the codes do not fit in the individual CPT fields, enter the remaining codes under Other CPT Codes & Units.

Understanding Testing Unit Limits

The limits shown above are Medicare Medically Unlikely Edit (MUE) values. An MUE identifies the number of units expected on the vast majority of correctly reported Medicare claims for the same patient, provider and date of service.

An MUE is not permission to automatically bill the maximum number of units. Every unit must be:

• Actually performed

• Medically necessary

• Supported by the documented time

• Permitted by the patient’s insurance

• Consistent with any authorization received

Commercial insurance, Medicare Advantage, TRICARE, TriWest, Medi-Cal and other payers may apply different limits or authorization requirements.

Common Medication-Management Codes

Medication-management appointments are generally reported using the appropriate outpatient Evaluation and Management code.

The E/M code must be selected based on the documented level of medical decision-making or applicable total-time requirements. Do not select the E/M code based only on the scheduled appointment length.

If separately identifiable psychotherapy was provided during the medication-management appointment, enter both the E/M code and the appropriate psychotherapy add-on code.

Example:

• 99214 – 1 unit

• 90833 – 1 unit

Codes 90833, 90836 and 90838 cannot be billed by themselves. They must be reported with an eligible E/M code. The psychotherapy service and time must also be separately documented.

Before Submitting the Online Billing Sheet

Please confirm that:

• Each client and date of service has its own row.

• All applicable columns have been completed.

• You scrolled to the right and reviewed the entire row.

• Every CPT code has a corresponding unit entry.

• Additional codes and units are listed under Other CPT Codes & Units.

• The appropriate ICD-10 diagnosis code has been entered.

• The patient’s telehealth location has been identified.

• All codes and units are supported by your documentation.

If you are unsure which CPT code or number of units to enter, please contact Help Therapy Billing before submitting the billing sheet.

Other Ways to Submit Your Billing

Although we prefer the online billing sheet, printable versions are also available if you need to complete your billing form manually and submit it by fax or email.

View printable billing forms and submission instructions

When possible, please use the online version. It helps us receive complete, legible billing information and process your services more efficiently.

Coding References

• CMS Medicare NCCI Medically Unlikely Edits

• CMS Psychological and Neuropsychological Testing Guidance

• CMS Psychiatry and Psychology Billing Guidance