Psychotherapy CPT Codes for Intervention Services
Psychotherapy CPT Codes for Intervention Services
Health behavior assessment and intervention services are used to identify and address the psychological, behavioral, emotional, cognitive, and interpersonal factors important to the assessment, treatment, or management of physical health problems. The patient’s primary diagnosis must be physical in nature and the focus of the assessment and intervention is on factors complicating the medical conditions and treatments. Psychotherapy CPT Codes for intervention services describe assessments and interventions to improve the patient’s health and wellbeing utilizing psychological and/or psychosocial procedures designed to ameliorate specific disease-related problems. In this article, we have discussed 2020 coding updates for health behavior individual as well as for group intervention.
Psychotherapy CPT Codes for Individual Intervention
- CPT code 96158 is reported for the initial 30 minutes of individual intervention and CPT code 96159 is reported in conjunction with CPT code 96158 for each additional 15 minutes needed to complete the intervention service.
- Only report add-on CPT code 96159 in conjunction with CPT code 96158.
- Do not report CPT code 96158 for less than 16 minutes of service.
- Do not report CPT code 96159 for less than 8 minutes of service.
- Do not report CPT code 96158/ CPT code 96159 on the same day as psychiatric services (CPT code 90785- CPT code 90899) or adaptive behavior services (CPT code 97151- CPT code 97158, 0362T, 0373T).
- For patients that require psychiatric services or adaptive behavior services, as well as health behavior assessment/intervention, report the predominant service performed.
- Evaluation and Management (E/M) services codes, including counseling risk factor reduction and behavior change intervention (99401- 99412), should not be reported on the same day as health behavior assessment and intervention codes by the same provider:
- These services can occur and be reported on the same date of service as long as the E/M service (99401-99412) is performed by a physician or other qualified health care professional (QHP) who may report E/M services.
- However, health behavior assessment and/or intervention services performed by a physician or other QHP who may report E/M services should do so using codes found in the E/M Services or Preventive Medicine Services sections of the CPT® Manual.
Psychotherapy CPT Codes for Group Intervention
- CPT code 96164 is reported for the initial 30 minutes of group intervention services provided to two (2) or more patients and CPT code 96165 is reported in conjunction with CPT code 96164 for each additional 15 minutes needed to complete the intervention service.
- CPT codes 96164 and ✚96165 can only be billed for groups of 2 or more patients and are billed for each individual patient.
- Only report add-on CPT code 96165 in conjunction with CPT code 96164.
- Do not report CPT code 96164 for less than 16 minutes of service.
- Do not report CPT code 96165 for less than 8 minutes of service.
- Do not report CPT code 96164/ CPT code 96165 on the same day as psychiatric services (CPT code 90785- CPT code 90899) or adaptive behavior services (CPT code 97151- CPT code 97158, 0362T, 0373T).
- For patients that require psychiatric services or adaptive behavior services, as well as health behavior assessment/intervention, report the predominant service performed.
- Evaluation and Management (E/M) services codes, including counseling risk factor reduction and behavior change intervention (99401-99412), should not be reported on the same day as health behavior assessment and intervention codes by the same provider:
- These services can occur and be reported on the same date of service as long as the E/M service (99401-99412) is performed by a physician or other qualified health care professional (QHP) who may report E/M services.
- However, health behavior assessment and/or intervention services performed by a physician or other QHP who may report E/M services should do so using codes found in the E/M Services or Preventive Medicine Services sections of the CPT® Manual.
CPT © Copyright 2021 American Medical Association
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