CPT Codes for Family Therapy Billing

By Katherine Ellison on Jun 18, 2024.

Fact Checked by Ericka Pingol.

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Introduction to CPT Coding

As the healthcare industry evolves, so do the tools and resources available to healthcare practitioners. One essential tool therapists use for billing purposes is the Current Procedural Terminology (CPT) codes for therapy. These codes are a standardized system used to identify specific medical services and procedures provided by healthcare practitioners, including family therapists.

In this article, we'll explore the importance of CPT codes for therapy billing and how they can help practitioners streamline their billing processes while ensuring compliance with insurance providers.

Let's dive in and discover how these codes can benefit you and your practice.

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Understanding the Three Categories of CPT Codes

Medical professionals who submit claims to insurance companies depend heavily on CPT codes. These codes are used to keep tabs on and analyze all the different kinds of medical work. There are three tiers of CPT coding, designated as Category I, II, and III, respectively. An explanation of the three CPT code types is provided below.

  • Category I: This category comprises codes identifying medical procedures and services widely performed in clinical practice. These codes are updated annually to reflect new medical procedures and technologies.
  • Category II: These codes are supplemental to Category I codes and are used to track performance measures. They are not required for billing but provide additional information about the services offered.
  • Category III: These codes are temporary and are used to track emerging technologies and procedures. They are meant to be temporary, as they are only valid for five years. They provide data for research and development and may be replaced with a Category I code if they become more widely adopted.

Healthcare practitioners must comprehensively understand the three CPT code categories to ensure accurate billing and efficient tracking of medical procedures and services rendered to patients.

For more information about CPT codes and their categories, visit our blog section and read our guide to using CPT codes.

Using the Correct Code to Bill Mental Health Family Therapy

Mental health family therapy is an essential part of healthcare that focuses on helping families and individuals manage their mental health challenges. When it comes to billing for mental health family therapy services, it's crucial to use the correct CPT codes for counseling. This ensures that healthcare providers are reimbursed relatively and accurately for their services.

The CPT codes for counseling are designed to provide a standardized coding system and bill mental health services. There are several codes that can be used for mental health family therapy, depending on the nature of the service provided. Selecting the appropriate code based on the session length and the service type provided is essential.

For example, the code 90847 is used for family psychotherapy with the patient present. In contrast, 90846 is used for family psychotherapy without the patient present. Similarly, the code 90834 is used for individual psychotherapy lasting 45 minutes, while 90837 is used for individual psychotherapy lasting 60 minutes.

Using the correct code for billing mental health family therapy is crucial to ensure that healthcare providers are paid fairly for their services. At Carepatron, we understand the importance of accurate billing and have designed our practice management software to make it easier for healthcare providers to manage their billing and coding needs.

CPT Code 90847: Family or Couples Therapy With the Patient Present

As a healthcare practitioner, you might be familiar with the CPT codes for occupational therapy evaluation, but have you heard of CPT Code 90847? This code is used for family or couples therapy with the patient present, and it is an essential tool for mental health practitioners.

Family or couples therapy is a type of therapy that involves multiple individuals rather than just one patient. With CPT Code 90847, mental health practitioners can bill insurance companies for therapy sessions that affect patients and their partners or family members. This code benefits practitioners working with patients with relationship issues or struggling with family dynamics.

It's important to note that CPT Code 90847 can only be used when the patient is present during the therapy session. If the patient is not present, then a different CPT code must be used. Additionally, this code cannot be used for individual therapy sessions.

If you're a mental health practitioner who provides family or couples therapy, then CPT Code 90847 is a code that you should be familiar with. By correctly understanding and using this code, you can ensure you properly bill insurance companies for your services while providing necessary support to your patients and their loved ones.

CPT Code 90846: Family or Couples Therapy Without the Patient Present

CPT codes for psychological testing and evaluation play a crucial role in healthcare. However, other codes are equally essential and widely used by healthcare practitioners. One such code is CPT Code 90846, which pertains to family or couples therapy without the patient present.

This code is used when a therapist provides counseling or therapy to a patient's family or partner in the absence of the patient. It allows the therapist to address issues within the family or relationship that may impact the patient's mental health.

The use of this code has become increasingly important as mental health practitioners recognize the critical role that family and relationships play in a patient's overall well-being. By addressing these issues, therapists can assist patients in developing more robust, healthier relationships and improving their mental health outcomes.

90847 Reimbursement Rates for Family & Couples Therapy

Staying informed about reimbursement rates is crucial for healthcare practitioners providing family and couples therapy services. Medicare lists the national payment amount for CPT Code 90847, which covers family psychotherapy with the patient present.

The reimbursement rates for CPT Code 90847 are as follows:

  • 2023: $99.63
  • 2022: $111.15
  • 2021: $102.59
  • 2020: $107.19

Family and couple therapists must know the latest reimbursement rates to ensure they are getting paid enough for their services. Even though Medicare rates might not directly apply to all payers or places, knowing about them can still be helpful for practitioners who want to give good care while staying financially stable.

Family Therapy Insurance Billing Example

When it comes to family and couples therapy, it's not always just one individual who requires treatment. In many cases, multiple family members or partners may need to participate in therapy sessions.

For example, let's consider the case of Client A (mom), Client B (child), and Client C (child). Client B is the individual who needs definitive treatment, but Client A and Client C are also involved in the family matter. After four sessions, here's how the therapy process might look:

  • Session 1: All three clients attend therapy together.
  • Session 2: The following week, the therapist sees Client A about Client B's treatment.
  • Session 3: The next day, Client B is seen individually.
  • Session 4: A week later, Client A decides that she needs therapy for her distress and sees the therapist about her treatment needs.

Family and couples therapy can involve various combinations of individuals in therapy sessions. The therapist must be able to assess each client's needs and tailor the treatment approach accordingly. By doing so, they can help individuals and families achieve improved mental health and well-being.

Final Thoughts

Understanding CPT codes is essential for any healthcare practitioner who provides family therapy services. With CPT codes, billing and reimbursement processes become more efficient and accurate while ensuring compliance with industry standards. However, it is essential to note the difference between CPT codes and HCPCS codes, as they serve different purposes in the billing process.

At Carepatron, we recognize the importance of staying up-to-date with the latest healthcare trends and assessment tools. That's why we offer practice management software solutions that streamline the billing and administrative processes, allowing healthcare practitioners to focus on what really matters: providing exceptional care to their patients.

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