Rainbow, this is my understanding of the new billing codes:

OLD / NEW
20-30 min / 30 min (16-37 min range)
45-50 min / 45 min (38-52 min range)
75-80 min / 60 min (53 or longer min range)

Even though the appointments are listed as either 30, 45, or 60, the CPT manual does provide guidance for billing and gives ranges, which I put in parentheses above. The APA says, "In general, you should select the code that most closely matches the actual time spent" with the client. So if a therapist spends 50 minutes with the client, they should select the 45 minute appointment code, since this covers appointments 38-52 minutes in length.

Rainbow, since there is no code that is a close match to a 90 minute appointment, it sounds like you are now being billed for 1 60 minute appointment and 1 30 minute appointment. Probably in the past,with the old codes, your T was fudging a little and billing you for 1 75-80 minute appointment when you were actually getting 90. I think an alternative to how she is billing you now might be to charge for 2 45 minute appointments instead of 1 60 and 1 30. So you could check to see which of those alternatives is cheaper. But it also could be possible that there is some prohibition on charging for the same service twice in one day.

One thing I notice is that the allowable ranges provide for appointments up to 7 minutes longer than the stated time. So the 30 minute code allows the appointment to last up to 37 minutes, and the 45 minute code allows the appointment to last up to 52 minutes. By extrapolation, a provider would use the 60 minute code for up to 67 minutes before needing to add a second service. So technically, I think your T could provide you with a 67 minute appointment at something close to your old rate. So this might be the way for you to go in striking a balance between maximizing time and minimizing cost.

Because your time with her is not billed by the minute, it's billed by the session.