Calculating Time for Psychotherapy Codes
Psychotherapy codes are used for billing clients and filing health insurance claims with all third-party payers, including Medicare and all private health insurance carriers, for psychotherapy services. All mental health professionals including psychologists, psychiatrists, nurses, and social workers delivering psychotherapy services use the same applicable CPT codes when billing clients and filing health insurance claims with third-party payers, including Medicare, Medicaid, and private health insurance carriers. All individual psychotherapy will be captured through one of three (3) following codes:
- 90832: Psychotherapy, 30 minutes with patient
- 90834: Psychotherapy, 45 minutes with patient
- 90837: Psychotherapy, 60 minutes with patient
Family or group psychotherapy will be captured through one of four (4) following codes:
- 90846: Family psychotherapy (without the patient present), 50 minutes
- 90847: Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes
- 90849: Multiple-family group psychotherapy
- 90853: Group psychotherapy (other than of a multiple-family group)
Exact Time of Session
The specific amount of time associated with codes titles may well differ from the actual time you provided psychotherapy. In general, you should select the code that most closely matches the actual time you spent. The CPT manual provides for flexibility by identifying time ranges in the descriptions of the three codes, as follows:
- 90832: 16 to 37 minutes
- 90834: 38 to 52 minutes
- 90837: 53 minutes or longer
- 90846, 90847: 26 or more minutes
Please note that the psychotherapy codes should not be billed for any sessions lasting less than 16 minutes. As part of adequate documentation of patient encounters in the record, be sure to note start and stop times for every session of psychotherapy you provide. From an insurance company’s standpoint, if you don’t record these details, you didn’t deliver the service.
Psychotherapy for Crisis
CPT code 90839 is the principal code for a crisis psychotherapy session requiring urgent assessment and history of the crisis state, mental status exam, and disposition. It is billed for the first 60 minutes of psychotherapy for a patient in crisis. If/when the crisis psychotherapy session lasts longer than 60 minutes, the add-on code, 90840, can be billed for each additional 30 minutes of psychotherapy for the crisis. In order for the new crisis codes to apply, the presenting problem must typically be life-threatening or complex and require immediate attention to a patient in high distress.
- 90839: Psychotherapy for crisis; first 60 minutes
- 90840: Psychotherapy for crisis; each additional 30 minutes (List separately in addition to code for primary service)
Session more than 60 minutes
Psychotherapy codes are not intended to limit the length of time you schedule for psychotherapy. Psychologists who conduct sessions that require more than 60 minutes should report CPT code 90837: Psychotherapy, 60 minutes with a patient. Regardless of how long the session lasts, the psychologist’s reimbursement will be based on the payment amount ultimately associated with 90837. Generally speaking, psychologists should periodically check their insurance carrier’s website for new policies on coverage and billing for services related to psychotherapy codes.
Time Apart from Session
The time spent arranging for services, providing reports, and communicating with other health care professionals is not included in the length of the psychotherapy session. Such activity is considered part of the post-service work already built into the psychotherapy codes. More detailed descriptions of pre-and post-service work for the psychotherapy codes 90832, 90834, and 90837 are as follows:
- Pre-service work: Prepare to see patient and/or the patient’s family member. Review the patient’s record. Communicate with other professionals and the patient’s significant others such as guardians, caretakers and family members.
- Post-service work: Arrange for further services. Coordinate care in writing or by telephone with patient, the patient’s family and other professionals such as the patient’s primary care provider. Document intra-service and post-service work activities. Provide written or telephone reports to third-party payers.
We hope that this article helped you to find the exact psychotherapy code based upon time. Still, if you are having any trouble with medical coding, you can contact us at 888-552-1290 / info@e2eMedicalBilling.com