Couples, Marriage, and Family Therapy

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Clinicians who engage in couples therapy can handle couples therapy in two ways. Option 1 includes a patient chart, note, and billing for the primary partner or family member only, whereas option 2 includes a patient chart, note, and billing for both partners or family members.

 

Option 1 

Create a patient chart, complete notes, and bill for the primary partner or family member only

Add Primary Patient Chart 

Decide which person in the couple serves as the primary patient. Add the primary party as a patient by clicking PATIENTS > “+Create New Patient”. Assign a clinician to the patient and fill out the “Patient Information” section. Under the “Contacts” section click the blue “+Create New Contact” button. Add the partner’s information. Click the green “Save New Patient” button. 

Scheduling Appointments 

Click SCHEDULING > “+Create New Appointment”. From the “Type” dropdown select the type that corresponds with couples therapy service codes in your account. To learn how to add service codes, see this article. Enter the primary patient in the “Patient” field and complete the rest of the fields accordingly. If desired, input the partner’s name in the “Appointment Alert” field. Click the green “Create Appointment” button. 

Notes 

Complete the note that corresponds with the scheduled appointment. Click “Edit” in the upper right of the note header. From the “Participants” dropdown select “Client and Others”. In the “Other Attendees” field enter the partner’s name. Click the green “Update Note Header” button. Finish the note as usual, inserting any information about the partner where appropriate. Write N/A in any field where additional information is not applicable. 

Billing 

Once the appointment is on the schedule the system automatically generates a billing line item in primary patient’s chart under the “Patient Billing” tab. 

 

Option 2

Create a patient chart, complete notes, and bill for both partners or family members

Add Patient Chart for Both Partners or Family Members 

Click PATIENTS > “+Create New Patient”. Assign a clinician to the patient and fill out the “Patient Information” section. Click the green “Save New Patient” button. Follow the process for the other partner. 

Scheduling Appointments 

Make sure your account has service codes for couples therapy saved under Group Therapy. To learn how to add service codes, see this article. Click SCHEDULING > “+Create New Appointment”. From the “Type” dropdown select “Group Therapy”. Add both partners into the “Patients” field. Fill out the rest of the fields accordingly, then click the green “Create Appointment” button.    

Notes 

Complete the corresponding group therapy progress note for each partner.   

Billing 

Once the appointment is on the schedule the system automatically generates a billing line item in each partner’s chart under the “Patient Billing” tab.  

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Comments

  • Avatar
    Heather Binns

    Remember that not all insurance companies will reimburse for couples or marriage counseling (ie NE Medicaid) because they don't consider it "medical necessity" and they may consider it insurance fraud if you bill it as "family therapy" when you're actually doing marriage counseling.

  • Avatar
    Deanna Clapsaddle

    With regard to Heather's comment in the case above, should we code this type of couples session under the primary patient as an"individual therapy" session or create a code for "couples" or "marriage counseling?" Is this what Danielle is talking about above, too, and is coding for an individual session for couples allowable or advisable in this case?
    Thanks.

  • Avatar
    Jordan

    Deanna,

    You will want to enter the primary patient and then when creating a note you can add a participant in the header of the note. In terms of the type of entry you will want to select "therapy session" In terms of a service code I would advise you to contact the insurance company to see if there was a specific code they would like you to use, Thank you.

  • Avatar
    Bruce Ruttenburg

    Neither of these options are appropriate for conjoint psychotherapy where my "patient" is the couple. In this case, there is no primary patient. So option 1 won't work. Option 2 is appropriate when I have two (or more) patients. That is not the case in conjoint psychotherapy. The patient is two people, and I need to make one note and bill them together.

  • Avatar
    Laura

    Bruce,

    I am sorry for any inconvenience. We are planning on incorporating a note template which would allow you to note and bill for conjoint therapy. In the meantime the two different workarounds are listed above.

  • Avatar
    Darci Cramer, Ph.D.

    Can each member in a couple, using Option 1, be allowed to create their own Patient Portal account? This way, either the mom or the dad (divorced) can schedule appointments.

  • Avatar
    Jordan

    Darci,

    At this time, we do not support the ability to have multiple client portal accounts for one patient. however, this is a feature that we can consider for a possible future update. for now, they can either share the portal account, or either parent can schedule appointments through the portal as a logged out user.

    If you have any questions please contact support at 215-658-4550 or via email at support@therapynotes.com. Thank you.

  • Avatar
    Katherine Yost

    Bruce is right.

  • Avatar
    Tatiana Morris

    I agree with Bruce, too. Not having a couple as one client is very inconvenient.

  • Avatar
    Jordan

    Tatiana/Katherine,

    Thank you for your feedback! We are planning on updating the note templates in a future update. If you have a specific template please forward to support@therapynotes and we can forward to management for review. If you have any additional questions please contact support at 215-658-4550.