Top 10 Psychotherapy CPT Codes Billed in 2019
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. The top 10 Psychotherapy CPT Codes Billed in 2019 by behavioral health providers and representatives are discussed in the article.
Top 10 Psychotherapy CPT Codes Billed in 2019
90837 – Psychotherapy, 60 minutes
Description: Individual psychotherapy, 60 minutes, with client and/or family member.
Time: 60 minutes (between 53 and 60 minutes)
90834 – Psychotherapy, 45 minutes
Description: Individual psychotherapy, 45 minutes, with the client and/or family member.
Time: 45 minutes (between 38 and 52 minutes)
90791 – Psychiatric diagnostic evaluation without medical services
Description: This code is used for an initial diagnostic interview exam that does not include any medical services. It includes a chief complaint, history of present illness, family and psychosocial history, and complete mental status examination. In the past, most insurers would reimburse for one 90791 per episode of illness. The guidelines now allow for billing this on subsequent days when there is medical necessity for an extended evaluation. (Use code 90792 for an initial evaluation with medical services.)
Time: There is no time range for this code.
Note: Medicare will pay for only one 90791 per year for institutionalized clients unless medical necessity can be established for others.
90847 – Family psychotherapy (with client present), 50 minutes
Description: Family psychotherapy (conjoint psychotherapy) (with client present). This code is used when the therapy includes the client and family members. It can also be used for couples therapy.
Time: 50 minutes
Notes: According to the American Psychological Association (APA), it’s covered by most insurance plans, and is challenged less often than 90846 because the client is present.
The other family psychotherapy codes are:
- Family psychotherapy, without patient, 50 minutes – 90846
- Family psychotherapy, a multiple-family group – 90849
- 90853 – Group psychotherapy (other than of a multiple-family group)
Description: Group psychotherapy (other than of a multiple-family group). This code relies on the use of interactions of group members to examine the pathology of each individual within the group. In addition, the dynamics of the entire group are noted and used to modify behaviors and attitudes of the client members. The size of the group may vary depending on the therapeutic goals of the group and/or the type of therapeutic interactions used by the therapist. The code is used to report per-session services for each group member. Note: Most insurance plans cover this procedure.
90846 – Family psychotherapy (without the client present), 50 minutes
Description: This code is used when the clinician provides therapy for the family of a client without the client being present.
Time: 50 minutes
Notes: Under Medicare rules, 90846 is only covered if the therapy is specifically intended to treat the client, not to treat the family members who may have issues because of the client’s illness. Some insurance payers do not cover sessions if the client is not present, however many will reimburse for this code.
90875 – Under other psychiatric services or procedures
Description: Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the client), with psychotherapy (e.g., insight-oriented, behavior modifying, or supportive psychotherapy).
Time: approximately 20-30 minutes
Note: Medicare will not reimburse for this code.
90832 – Psychotherapy, 30 minutes
Description: This is one of the three timed psychotherapy codes. This code is less commonly used than the other two codes.
Time: 30 minutes (between 16 – 37 mins)
90838 – Psychotherapy, 60 minutes, with E/M service
Description: Individual psychotherapy, 60 minutes with client and/or family member when performed with an evaluation and management (E/M) service.
Time: 60 minutes (between 53 and 60 minutes)
99404 – Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure)
Time: 60 minutes (between 53 and 60 minutes)
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To get reimbursed accurately for Psychotherapy therapy codes, using the correct CPT code and supporting documentation is essential. It increased clean claim submission percentage as well as reduces denials. E2E Medical Billing Services is known for its accurate Psychiatry and Psychology billing and coding. To know more about our mental health medical billing and coding services call us at 888-552-1290 or write to us at [email protected]