Current Procedural Terminology (CPT) codes are a standardized system used within the United States to designate medical operations and services delivered by healthcare practitioners. CPT codes, which are developed and maintained by the American Medical Association (AMA), are critical for correct billing and reimbursement of medical services. Each code is made up of five alphanumeric characters and is used to identify and define a particular medical operation or service, such as an office visit, surgery, laboratory test, or diagnostic imaging. CPT codes are revised on an annual basis, and healthcare practitioners must stay up to date on the most recent codes and rules to guarantee accurate documentation and compensation for their services. To help you get started, we’ve created this guide containing the top CPT 10 codes for therapy.
What are CPT Codes for therapy?
CPT therapy codes are essential for the description and billing of therapeutic services provided by therapists, psychologists, counselors, and more. They can be used as evaluation codes to assist and evaluate patient conditions, which also encompasses several different measurements, observations, and tests. CPT therapy codes can also be used for interventions, as well as reevaluations when progress is needed to be reassessed regarding the patient's mental health.
Mental health codes are located within the psychiatry section of the CPT code set. The CPT code set contains over 8000 codes, published by the AMA, however, you only need to concern yourself with codes 90785-90899. The codes are organized within distinct categories based on the psychological profession, such as psychiatry, psychotherapy, and more. The CPT codes can also be used by a variety of mental health professionals, including clinical psychologists, licensed marriage and family therapists, social workers, and many others.
Categories of mental health CPT codes
Mental health CBT codes are organized into four main categories. This allows you to use CBT cards appropriately, and look for the corresponding code in a shorter amount of time. You can utilize these codes for counseling, occupational therapy, and more. These four categories include the following.
Psychiatric Diagnostic Interview
- Code 90801: Psychiatric diagnostic interview examination
- Code 90802: Interactive psychiatric diagnostic interview examination
Psychiatric Therapeutic Services
- Codes 90804-90809: Insight-oriented, behavior modifying and/or supportive psychotherapy
- Codes 90810-90815: Interactive psychotherapy
Family Medical Psychotherapy
- 90846: Family psychotherapy (without the patient present)
- 90847: Family psychotherapy (with the patient present)
- 90849: Multiple-family group psychotherapy
- 90853: Group psychotherapy (excluding a multiple-family group)
- 90857: Interactive group psychotherapy
Top CPT codes for therapy
It can be tricky to wrap your head around all the mental health CPT codes, which is why we’re here to help. We’ve created a list of the most useful CBT therapy codes that you are likely to use within your therapy services for physiological testing and evaluation. That way, you only have to familiarize yourself with the following.
90791: Psychiatric Diagnostic Evaluation (Initial Assessment)
This code is used for psychiatric diagnostic evaluations, which are often integrated with biopsychosocial assessments, client medical and mental health history, family communication, and treatment recommendations. It is commonly used for the initial assessment of the client, and once per year afterward for annual progress analysis. Because it is an extensive assessment, it need only be used once per year at treatment onset.
90834: Individual therapy for ~45 minutes
This is used for therapy sessions that take around 45 minutes in face-to-face length and is used when helping support individuals with behavior modification or support for psychotherapy. Recreational therapy, such as dance or art, is not to be included within this code, as well as any taught grooming skills.
90837: Individual psychotherapy for ~60 minutes
Similar to the previous one, this code involves extensive therapy sessions, but with more detailed information. Sometimes, insurance companies consider this code for acute crises within the PTSD, OCD, and panic disorder contexts. As a result, make sure that you have a clear justification within your progress notes for this type of code. Recreational therapy, social interactions, daily living activities, and grooming skills should not be covered within this code.
90832: Individual psychotherapy for ~30 minutes
This is used for psychotherapy practices that take a shorter amount of time. Keep in mind that this does not include documentation time, as well as recreational therapy or grooming skills.
90847: Family or couples therapy with patient present
This code can be used for family and/or couples therapy sessions that are 26 minutes or longer. The sessions can be face-to-face or administered via telehealth services. This code is used for specific client treatment within a family or couple relationship context and is used when the therapist wishes to observe and correct the client's behaviors through psychotherapy techniques. However, this code is not used when evaluating family history or updating patient behavior and a follow-up appointment.
90839: Psychotherapy for crisis; first 60 minutes
This code is used for the first 60 minutes of psychotherapy with a client in a crisis. if the patient needs an urgent assessment of their current mental health state, as well as their history, then this is the best code to use. It is for face-to-face therapy sessions and does not include documentation time. The conditions presented must be life-threatening or complicated, and must warrant immediate attention to reduce distress. This is not to be used in conjunction with social interaction, recreational therapy, daily living activity monitoring, and grooming skill evaluations.
90840: Psychotherapy for crisis; Each additional 30 minutes
It is important to note that if your psychotherapy crisis session lasts longer than 60 minutes, it is recommended that you use this add-on code. This bills for each additional 30 minutes of psychotherapy for crisis and should be listed separately.
90853: Group psychotherapy
This code pertains to group member interactions used within therapy group sessions. If you wish to examine the mental health of an entire group of individuals and enforce positive and healthy group dynamics, that are not part of a multiple-family group, then consider this code. Compared to many others, this code is also not time-based.
90875: Under other psychiatric services or procedures
This code is within a 20 to 30-minute time span and includes any individual psychophysiological therapy that incorporates psychotherapy techniques. This must consist of a face-to-face component, as well as a behavior-modifying or supportive psychotherapy aspect.
99404: Under preventative medicine, individual counseling services
This is utilized for risk factor reduction interventions and/or preventative medicine counseling. This code has a time of 60 minutes, functionally between 53 and 60 minutes.
Hopefully, this guide has provided you with the knowledge to effectively use CPT therapy codes without contention or hesitation. Reviewing these codes is a great way to consolidate your knowledge, and ensure that you are using them appropriately, and within the right context. This will allow for more accurate billing and insurance processes, as well as faster reimbursements. Familiarizing yourself with CPT codes is an excellent practice that can boost the level and quality of services you provide.