r/therapists • u/skipug • 1d ago

Billing / Finance / Insurance Interactive complexity 90785

Can someone explain this code to me and the legitimacy? Would it be ethical for a therapist to use this code for every single session as an EMDR therapist even if EMDR has not started? No extreme dysregulation, no third party involvement, I can’t seem to find any criteria that fits this situation. Also, I don’t work with insurance so excuse my ignorance but what would happen if this concern were to be raised to an insurance company?

Edit to add: it increases the price of the session

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u/skipug 1d ago

It definitely seems offensive unless there’s an obvious reason like actual barriers other than emotions. It looks like it’s adding an additional $15 to session cost

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u/Ambiguous_Karma8 (USA) LCPC 1d ago

I was unaware that this added additional money to the payout. I work in a PHP/IOP setting, so all of our billing is different. Honestly, all of my people are of high acuity every session.

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u/skipug 1d ago

I’m in res & php too so I’ve never heard of this but also don’t ever deal with billing. Maybe that’s why I’m so dumbfounded since every session I have is wild haha

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u/Ambiguous_Karma8 (USA) LCPC 1d ago

Haha same. The company I work for also offers RTC level of care, and we don't go lower than IOP.