January 15, 2013 in Managing Your Practice
It may not have been part of your New Year’s resolutions, but starting January 1st, all providers of psychotherapy services began (or should have begun) using the 2013 psychotherapy CPT codes when billing insurance plans, Medicare, or third-party payers for mental health services.
While the codes for testing and health and behavior were left untouched, virtually all of the codes for psychotherapy services have been revamped under the new coding system.
Here are the basics of the new CPT codes:
Diagnostic interview 90791 Diagnostic interview w/medical services 90792 Psychotherapy 30 minutes (*16-37 min.) 90832 Psychotherapy 45 minutes (*38-52 min.) 90834 Psychotherapy 60 minutes (*53+ min.) 90837
*per CPT time rule
These codes replace the codes you have probably become very familiar with in the course of your practice. Unless you have the need to resubmit a claim for 2012, codes such as 90806, 90801, etc., should be permanently mothballed. A few that did make the cut and were retained under the 2013 codes: Family Psychotherapy (90846, 90847, 90849) as well as Group Psychotherapy (90853). These procedures will continue to be coded as they have in the past. The only new twist is the ability to use an “add-on” code with CPT 90853 (see below).
There are a few new bells and whistles that come with the 2013 psychotherapy CPT codes. The new coding includes an “add-on” that allows you to bill for factors that complicate your therapy with your patient. Complicating factors can include things such as the need for an interpreter, the need for a family member or someone like a probation officer to participate in the therapy, the use of play equipment, wrangling a highly-charged family member, or working with a child with limited verbal skills. This special add-on code can only be used with specific 2013 psychotherapy CPT codes and cannot be used by itself.
Interactive complexity code +90785
May be used with CPT codes:
90791, 90792, 90832, 90834, 90837, 90853
The new coding also includes a special category for crisis psychotherapy. Typically, to meet the criteria of a crisis session, a patient must present with a life-threatening situation that requires your urgent assessment and the immediate handling of the current crisis. (A “stressed-out” patient who wants an appointment a.s.a.p. doesn’t count.) To bill under the crisis code you must also meet with the patient for at least 30 minutes.
Crisis code (first 60 minutes of psychotherapy) 90839 Crisis code add-on for each additional 30 minutes of psychotherapy +90840
This is just a brief overview of the changes to the CPT codes. I encourage you to learn more about the 2013 Psychotherapy CPT codes by visiting the American Medical Association website. Copies of the 2013 CPT® manual are available online at the AMA bookstore.
CPT® is a registered trademark of the American Medical Association (AMA). CPT® five-digit codes, descriptions, and other data are copyright 2011 by the American Medical Association (AMA).Heather Hill-Spaine
Copyright © 2013 Real Psych Practice LLC