The last time the CPT Codes changed was in 1998. Due to changes in services being provided – primarily an increase in intensity of services needed and comorbidity in treatment focus – mental health providers are now providing outpatient services to more clients who are presenting with increased complexity and higher risk symptoms.
If you work directly with managed care or if you provide a “superbill” to your clients, you will find this free webcast by the American Medical Association on the changes in the CPT Codes to be particularly informative. Included in the presentation are details like . . .
- 90791 and 90792 may be used for reassessments if needed as well as for initial assessment;
9087590785 (Interactive Complexity) may be used as an “add on” code when one of the following exists – high reactivity or anxiety, conflict (including disagreement among family members about direction of treatment), emotional or behavioral conditions that complicate treatment and compliance, any situation involving mandated reporting (to governmental authority), or use of interpreters, devices, or tools for the purposes of augmenting communication due to language barriers (due to expression or age); [corrected 01-09-13 thanks to Andrea Davis, LPC, ATR-BC)
- The CPT “Time Rule” is actually based on a range of time (see webcast for details) rather than a fixed time of 30, 45, or 60 minutes;
- When a minimum of 90 minutes has been spent on psychotherapy services, an “add on” (99354-99357) code may be used to report Prolonged Services with 90837;
- When using “add on” codes, it is important to separately identify the conditions / criteria that allow for the base and “add on” codes in your notes;
- There were no changes in coding for family psychotherapy. It remains important to clearly distinguish between “family psychotherapy” (where the focus is the family or a subset of the family) and “psychotherapy with patient or family” (where the focus is on the patient but may occasionally include the family to support that work);
- 90846 may be used for telephone / email contact with client;
- 90839 (Crisis Psychotherapy) can be for no less than 60 minutes but this time does not have to be continuous; and,
- 90875 (Interactive Complexity) may be used as an “add on” with group therapy (as well as with initial assessments and psychotherapy with patient or family).
I found this webcast to be extremely helpful and informative. I hope you do, too. However, I am by no means an expert in coding. I’m just sharing resources as I run across them.