Child & Adolescent Psychiatry Billing Services

Child and adolescent psychiatry billing has quirks that adult practices do not face. A visit may involve a parent, a teen, and sometimes a school, and the claim must show who took part and why. Insurance may sit with a parent, a guardian, or a state program, which complicates eligibility and consent.

Practices also mix evaluation and management visits, psychotherapy add-ons, and family sessions. Getting these combinations right takes care. Westmont Revenue Partners connects child and adolescent psychiatry practices with vetted billing experts who understand these workflows and can support the full revenue cycle.

Who this is for

• Child and adolescent psychiatrists in private practice
• Psychiatric nurse practitioners and physician assistants working with youth
• Group practices that also employ therapists
• Clinics inside pediatric, school-based, or community programs
• Telepsychiatry practices serving families across a region

What gets billed

• Diagnostic evaluations, with or without medical services
• Follow-up medication management visits
• Psychotherapy add-ons billed with an evaluation and management visit
• Stand-alone individual psychotherapy
• Family therapy with or without the patient present
• Interactive complexity when communication barriers are present
• Brief emotional or behavioral assessments
• Care coordination with schools and pediatricians
• Telehealth visits where payers allow them
• Crisis visits and urgent follow-up

Commonly billed codes

Code	Type	What it covers
90791	CPT	Psychiatric diagnostic evaluation without medical services
90792	CPT	Psychiatric diagnostic evaluation with medical services
99214	CPT	Established patient office visit of moderate complexity
90833	CPT	Add-on psychotherapy, about 30 minutes, with an E/M visit
90836	CPT	Add-on psychotherapy, about 45 minutes, with an E/M visit
90832	CPT	Stand-alone individual psychotherapy, about 30 minutes
90834	CPT	Stand-alone individual psychotherapy, about 45 minutes
90785	CPT	Add-on for interactive complexity
90846	CPT	Family therapy without the patient present
90847	CPT	Family therapy with the patient present
F84.0	ICD-10-CM	Autistic disorder, a common diagnosis in child psychiatry

Note

Codes are examples for orientation, not a complete list, and do not guarantee coverage or payment. Always check current code sets and payer policy.

Billing challenges in child and adolescent psychiatry

• Who is the patient and who is the subscriber. The child is the patient, but the policy belongs to a parent. Billers verify the right member ID and date of birth, especially with split households.
• Family sessions. A family code needs the right setup, and the patient may or may not be in the room. Billers check that notes match the code chosen.
• Add-on psychotherapy with E/M. The therapy portion must be separate and timed, and the E/M level should stand on its own. Billers review notes so both pieces are supported.
• Interactive complexity. This add-on applies only in defined situations, such as caregiver conflict or the use of play materials. Billers confirm the documentation reflects the specific criteria.
• Minor consent and privacy rules. Teen consent and explanation of benefits rules vary by state and payer. Billers help set up confidential communication preferences where the law allows.
• Medicaid and state program rules. Many children are covered by Medicaid or CHIP, and rules vary by state. Billers keep separate payer rules and check for managed care carve-outs for behavioral health.
• School and agency coordination. Time spent with schools may not be billable on its own. Billers learn what each payer allows before charges are posted.

How Westmont can help

• Matching you with vetted billing experts experienced in child and adolescent psychiatry
• End-to-end revenue cycle support, from eligibility to payment posting
• Denial management for add-on code and family therapy rejections
• Help with credentialing for psychiatrists, nurse practitioners, and therapists
• Clear reporting for practice owners

Frequently asked questions

Can we bill a psychotherapy add-on with a medication visit?

Yes, in many cases. The add-on is billed with an E/M visit when you provide separate, timed psychotherapy. Both services need their own documentation, and the E/M level should not rely on the therapy time. Payer rules vary, so confirm policies before billing both.

How do we bill a family session when the child is not in the room?

Family therapy codes differ based on whether the patient is present. Use the code that matches who attended. The note should explain why the session was needed and how it relates to the child's treatment. Some payers ask for extra detail on these claims.

Who gets the explanation of benefits for a teen's visit?

The statement usually goes to the policyholder, which may be a parent. Rules on confidentiality for minors differ by state and by payer. Ask each plan about confidential communication requests, and set a clear front-desk process so families know what to expect.

What is interactive complexity and when can we use it?

It is an add-on for visits made harder by factors like conflict among caregivers, mandated reporting, or the use of play equipment to communicate with a young patient. It does not apply to routine language support. Notes must show which factor applied.

Do Medicaid plans cover child psychiatry visits by telehealth?

Many do, but rules differ by state and plan. Some limit certain codes or require specific modifiers or place-of-service codes. Check your state Medicaid manual and each managed care plan, and review telehealth policies again every year.

Related billing services

• Psychiatry Billing
• Pediatric Billing
• Adolescent Medicine Billing
• Psychology Billing
• ABA Billing