Cpt codes for Psychiatry Medical Billing
Current Procedural Terminology (CPT) is a specialized and standardized medical codeset developed and maintained by the American Medical Association. CPT codes are five digital numeric codes that define and describe the intricacies of all medical procedures, ranging from psychotherapy to radiology and surgery. These codes are crucial if behavioral health medical billers want to get reimbursed for the service they provide in full and avoid insurance audits.
Insurance companies generally reimburse depending upon various factors, including geographical location and professional credentials. However, using the right CPT codes and add-on codes in psychiatry medical billing is paramount to indicate the exact medical service and determine the payment. Accidental or other errors may directly affect an insurance company’s service payments.
Psychiatry Medical billing CPT codes are nuanced and numerous, and thus this guide will help you traverse through the complicated world of common psychiatry CPT codes and psychiatry add-on codes.
Let’s get started!
Common Psychiatry Medical Billing CPT Codes
There are a few medical billing CPT codes for psychiatry services that behavioral health medical billers can use and are reimbursed at different rates from each other.
Let us look at this list of the most common insurance billing codes for psychiatry services:
Diagnostic, Evaluation, Intake CPT Codes
Following are the two most typical diagnostic, evaluation, intake CPT codes:
Psychiatric Diagnostic Evaluation code excluding medical services. This code generally covers just one client
Psychiatric Diagnostic Evaluation code, including medical services.
Outpatient Mental Health CPT Codes
Here is a list of the most common outpatient mental health CPT codes:
30 minutes (16 to 37 minutes) of Psychotherapy
45 minutes (38 to 52 minutes) of Psychotherapy
60 minutes (53 minutes and more) of Psychotherapy
Family or couples therapy (without the patient present)
Family or couples therapy (with the patient present)
60 minutes (30-74 minutes) of Psychotherapy for crisis
Add on code for an extra 30 minutes (75 minutes and over) of Psychotherapy for a crisis, used in conjunction with 90839
Psychotherapy CPT Codes with Evaluation and Management Services
Following are the most typically used psychotherapy CPT codes with evaluation and management services:
30 Minutes of Psychotherapy With Evaluation And Management
45 Minutes if Psychotherapy With Evaluation And Management
60 Minutes of Psychotherapy With Evaluation And Management
Mental Health Add-On CPT Codes
Let us look at a brief list of the most typical add-on codes for routine outpatient mental health billing:
Add-On CPT Code 90785
Used for interactive complexity. For instance, play therapy with soothing dolls or other toys. This interactive complexity add-on is not a payable expense but only depicts that the treatment availed was complicated in nature.
Add-On CPT Code 90863
Used for Pharmacologic Management after therapy.
Add-On CPT Code 99050
Used for psychiatry services offered at times other than the commonly scheduled office hours or in the office when it is generally closed.
Add-On CPT Code 99051
Services offered in the psychiatry office during typically scheduled evenings, holiday office hours, or the weekend.
Add-On CPT Code 99354
Used for extra time after the additional time of 74 minutes. This code adds another thirty minutes to the billing but is only usable when the session duration spans at least 90 minutes for 90837 or 80 minutes for 90847.
Add-On CPT Code 99355
This add-on code adds extra time after the first sixty minutes. The first additional spans 30 to 74 minutes
Add-On CPT Code 90840
This add-on code depicts additional thirty minutes of psychotherapy for crisis and is only used in conjunction with CPT 90839
Add-On CPT Code 90833
This code adds 30 minutes to the psychotherapy. For instance, it is used when a psychiatrist monitors the medication response and then holds a 30-minute session.
Add-On CPT Code 90836
This is a 45 minutes psychotherapy add-on code. For instance, it can be used when a clinical nurse specialist monitors the medication response and then holds a 45-minute session.
Outpatient Psychiatry CPT Codes
Following are the most common outpatient psychiatry CPT codes:
10 minutes of New Patient Office Visit
20 minutes of New Patient Office Visit
30 minutes of New Patient Office Visit
45 minutes of New Patient Office Visit
60 minutes of New Patient Office Visit
5 minutes for Established Patients
10 minutes for Established Patients
15 minutes for Established Patients
25 minutes for Established Patients
40 minutes for Established Patients
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Dr. Josh is a physician who's helping spread the knowledge about Telehealth and its advantages. At SmartClinix, he's providing his expertise and knowledge in the form of engaging articles on various health & tech related topics.