Psychiatrist billing codes


CPT Codes for Behavioral Health Billing [Updated for 2022]

Current procedural terminology (CPT) codes are essential components of the health insurance billing process. It's critical to use the appropriate procedure codes to receive reimbursement for your services and avoid an audit. However, using the correct CPT codes for medical billing involves understanding a complex system.

There are thousands of codes to choose from and many different guidelines to follow. Nevertheless, it is possible to use medical codes properly and receive maximum reimbursement rates for your services.

This post will cover some basics of CPT codes for mental health, and provide tips for avoiding claim denials. The better you understand current procedural terminology, the more time you'll have to care for patients, and the easier it will be to get paid.

Table of Contents

  • What Are CPT Codes?
  • Why CPT Codes Are Essential for Clinicians
  • How Do CPT Codes Work?
  • What Are the Three Categories of CPT Codes?
  • How to Use the Correct CPT Code in Psychiatry
  • The 3 Major Components of E/M Documentation
  • The Most Common Psychotherapy CPT Codes
  • Psychotherapy Crisis Codes
  • Other Add-On Codes
  • Mental Health Test and Assessment Codes
  • Psychiatry CPT Codes
  • Psychiatry Evaluation and Management Codes
  • Common Behavioral Health Case Management CPT Codes
  • Telehealth CPT Codes
  • New CPT Codes for Behavioral Health Services
  • How CPT Code Changes Impact the Reimbursement Process
  • CPT Code Reimbursement Rates
  • Tips for Maximizing Reimbursement and Avoiding Insurance Claim Denials

What are CPT Codes?

CPT is a uniform coding system developed by the American Medical Association (AMA). The AMA first established this system in 1966 to standardize terminology and simplify record-keeping for physicians and staff. Since its development, CPT has undergone several changes. The most recent edition focuses on using CPT codes to report physician services.

CPT codes describe medical procedures — such as tests, evaluations, surgeries, and other practices — performed by a physician on a patient. For example, behavioral health CPT codes describe the length of a psychotherapy session with a client or a diagnostic interview. CPT codes are necessary to receive reimbursement from health insurance companies.

Why CPT Codes Are Essential for Clinicians

CPT codes are essential parts of practice management for clinicians and health care staff because they determine compensation and the practice's overall success. To receive the correct reimbursement rates, clinicians must ensure the codes on insurance claim forms accurately reflect the services they provided before submitting the claims to insurance companies.

How Do CPT Codes Work?

CPT coding tells insurance payers what you would like to get paid for. Along with the International Classification of Diseases codes, CPT codes paint a complete picture for health insurance companies, and you need both types for reimbursement.

The ICD code set describes the diagnosis and why the treatment was necessary, and the CPT code explains the services provided. Examples of mental health ICD codes include the following.

  • F41.9: Anxiety disorder
  • F31.31: Bipolar disorder, current episode depressed, mild
  • F42: Obsessive-compulsive disorder
  • F43.11: Post-traumatic stress disorder, acute

For example, a social worker might use F41.9 with CPT code 90832, which is the code for individual psychotherapy for 30 minutes, to bill for a session with a client experiencing anxiety. You would include both codes on a health insurance claims form.

There are three distinct categories of CPT codes, which we will look at next.

What Are the Three Categories of CPT Codes?

The three categories of CPT codes are as follows.

  • Category I: Most coders spend the majority of their time working with Category I codes. There are different sections of these codes based on the field of healthcare. The six sections of the CPT codebook are Evaluation and Management, Medicine, Surgery, Radiology, Anesthesiology and Pathology, and Laboratory. Each has a unique set of guidelines. The CPT codes under Category I are five digits long.
  • Category II: Category II codes contain four digits, followed by the letter F. Category II codes are optional. They provide additional information and are not a replacement for Category I or Category III codes.
  • Category III: Category III codes are temporary and represent new or experimental procedures or technology. For example, if you can't find a new practice in Category I, you might use a Category III code. Category III codes are four digits long and end in the letter T.

Since Category I is the most frequently used, here's a look at the numerical range of codes within this category.

  • Evaluation and Management: 99202 to 99499
  • Anesthesia: 00100 to 01999 and 99100 to 99150
  • Surgery: 10021 to 69990
  • Radiology: 70010 to 79999
  • Pathology and Laboratory: 80047 to 89398
  • Medicine: 90281 to 99199 and 99500 to 99607

Each of these sections contains subfields to correspond to a particular healthcare field and include guidelines to follow. For example, therapists commonly use psychotherapy CPT codes falling in the range of 90832 to 90853 under the Medicine's psychiatry section. Psychiatrists, primary care physicians, and other authorized prescribers might use evaluation and management codes for providing general medical services.

CPT codes also have various modifiers. Modifiers have two numbers or letters, and you can add them to a CPT code. They describe specific critical parts of a procedure.

Some codes have instructions below them in parentheses to tell the coder there may be a better code to use. Codes must be as specific as possible for a mental health billing claim to get accepted.

How to Use the Correct CPT Code in Psychiatry

The CPT code set is a complex system. It is not always easy to determine if you've met the required elements to code appropriately for the maximum reimbursement amount. It may help to break the process down into steps for new and established patients.

First, you might bill two types of psychiatric service or procedure CPT codes for new patient office visits. These are:

  • E/M codes
  • Psychiatric diagnostic evaluation codes

Depending on the situation and time involved, it may be appropriate to bill for both codes. Here are a few guidelines to follow.

  • E/M: Use E/M codes when evaluating a new medical issue. With the AMA's 2021 coding changes, you can select an E/M code based on the complexity of medical decision-making or the total time you spent on the patient's care on the day of the encounter. If you provide E/M services with a psychotherapy add-on code, you must choose a code based on medical decision-making and not total time.
  • Psychiatric diagnostic evaluation: Use psychiatric diagnostic evaluation codes for a diagnostic assessment. You may need to use these codes more than once if it takes more time to complete the initial evaluation.

Regarding established patients, the rules allow you to bill an E/M service with every psychotherapy visit, but they don't require you to do so with every encounter. Only bill E/M services if you addressed and documented a separate medical issue during the visit.

For example, if you address medication's side effects during an encounter, you might bill for an E/M visit in addition to a psychotherapy session.

However, if a patient has been stable and on the same medication for years and attends a psychotherapy visit, you can only bill for the psychotherapy session. You cannot bill for E/M because there are no medical or medication concerns expressed during the visit.

Also, to bill for E/M, your documentation must prove your active management or discussion of a medical or medication problem distinct from the psychotherapy service.

The 3 Major Components of E/M Documentation

According to the Centers for Medicare and Medicaid Services, insurance companies might want to see documentation to ensure the client's policy covers necessary services and confirm the following pieces of information:

  • The service site
  • The medical necessity of the services provided
  • The accuracy of the services reported

Your client's medical records must include the following three components to support the E/M codes you choose.

  • History: The history section must include the history of present illness, a review of body systems, and the family and social history.
  • Examination: The examination section includes the type of examination performed based on your judgment and the nature of the problem. According to the CMS, the levels of E/M services derive from problem-focused, expanded problem-focused, detailed, or comprehensive exams.
  • Medical decision-making: The medical decision-making section includes the number and complexity of problems addressed during the specific encounter, the complexity of the data reviewed, and the risk of complications.

When selecting an E/M code with psychotherapy, you'll base your choice on medical decision-making. It's also necessary to choose a CPT code that reflects the service site and whether the patient is new or established. Take these steps:

  • Select the type and level of E/M service based on medical decision-making.
  • Choose timed psychotherapy add-on codes based on the time spent providing psychotherapy.

For example, if you choose E/M code 99202 to evaluate and manage a new patient in an outpatient setting with straightforward decision-making and need to bill for 30 minutes of psychotherapy, you would include the add-on code 90833.

Make sure to keep your E/M code and psychotherapy codes separate. The time associated with the E/M service cannot count toward the time of the psychotherapy service. The E/M service must be significant and distinct from psychotherapy.

The Most Common Psychotherapy CPT Codes

While family therapists and counselors may not use E/M codes like psychiatrists or primary care physicians, they will bill for psychotherapy services. The American Psychological Association lists standard CPT codes used by therapists.

  • 90832: 30 minutes of individual psychotherapy
  • 90834: 45 minutes of individual psychotherapy
  • 90837: 60 minutes of individual psychotherapy
  • 90845: Psychoanalysis
  • 90846: 50 minutes of family psychotherapy without the client present
  • 90847: 50 minutes of family psychotherapy with the client present
  • 90849: Multiple-family group psychotherapy
  • 90853: Group psychotherapy

Though CPT codes describe specific times, such as 30, 45, and 60 minutes, therapists have some flexibility, since sessions might go over or under that exact amount.

When choosing a psychotherapy CPT code, therapists must select the closest one to the time spent in the session. The APA lists the following psychotherapy session durations.

  • 90832: Choose this code for sessions that run between 16 and 37 minutes.
  • 90834: Select this code for sessions that are 38 to 52 minutes long.
  • 90837: This code is appropriate for sessions lasting 53 minutes or longer.
  • 90846 or 90847: Choose these codes for 26 minutes or more of family psychotherapy.

Psychotherapy Crisis Codes

CPT codes for crises allow behavioral health professionals to bill for emergency sessions. Care providers typically use the following crisis codes for patients in great distress who require immediate attention or are in a life-threatening situation.

  • 90839: First 60 minutes of psychotherapy for crisis
  • 90840: Add-on code for each additional 30 minutes of psychotherapy for crisis
  • 99050: Add-on code for services provided when the office is usually closed
  • 99051: Add-on code for services provided during regularly scheduled hours on evenings, weekends, or holidays

If a crisis session falls below 60 minutes, you will bill for a regular psychotherapy code, such as 90834.

Other Add-On Codes

Providers may use add-on codes to describe additional services. Behavioral health clinicians can only apply add-on codes in combination with psychotherapy and diagnostic evaluation services. Providers must include the principal CPT code and add-on code on the billing form, and list them separately. Add-on codes include the following.

  • 90785: Interactive complexity
  • 90863: Psychopharmacology with psychotherapy
  • 90833: 30 minutes of psychotherapy with E/M service
  • 90836: 45 minutes of psychotherapy with E/M service
  • 90838: 60 minutes of psychotherapy with E/M service

Clinicians might use code 90785 for factors that complicate service delivery, such as a client's angry family member or a third party like a probation officer. Psychologists might use code 90863 when reviewing or prescribing medication on the same day as delivering psychotherapy services. Psychiatrists do not use code 90863.

Mental Health Test and Assessment Codes

CPT codes for mental health tests and assessments include the following.

  • 96105: Aphasia assessment
  • 96110: Developmental screening
  • 96112: Developmental test administration with interpretation
  • 96113: Each additional 30 minutes of developmental test administration with interpretation
  • 96116: Neurobehavioral status exam, 60 minutes
  • 96121: Each additional hour of neurobehavioral status examination
  • 96125: Standardized cognitive performance testing, 60 minutes
  • 96127: Brief emotional or behavioral assessment
  • 96130: Psychological testing evaluation services provided by a physician or qualified health professional, 60 minutes
  • 96131: Each additional hour of psychological testing evaluation services performed
  • 96132: Neuropsychological testing services, 60 minutes
  • 96133: Each additional hour of neuropsychological testing services performed
  • 96136: Psychological or neuropsychological test administration and scoring by a physician or qualified health professional, 30 minutes
  • 96137: Each additional 30 minutes of neuropsychological test administration and scoring by a physician or qualified health professional
  • 96138: Psychological or neuropsychological test administration and scoring by a technician, 30 minutes
  • 96139: Each additional 30 minutes of neuropsychological test administration and scoring by a technician
  • 96146: Psychological or neuropsychological test administration via an electronic platform with automated results
  • 96156: Health assessment or reassessment
  • 96160: Patient-focused health risk assessment
  • 96161: Caregiver-focused health risk assessment

Psychiatry CPT Codes

Psychiatrists use CPT codes to bill for psychiatric diagnostic evaluations, psychotherapy, and other psychiatric services. CPT codes for psychiatric services include the following.

  • 90791: Psychiatric diagnostic evaluation without medical services
  • 90792: Psychiatric diagnostic evaluation with medical services
  • 90865: Narcosynthesis
  • 90867: Therapeutic repetitive transcranial magnetic stimulation
  • 90870: Electroconvulsive therapy
  • 90875: 30 minutes of individual psychophysiological therapy with biofeedback
  • 90876: 45 minutes of individual psychophysiological therapy with biofeedback
  • 90880: Hypnotherapy
  • 90899: Unlisted psychiatric procedure or service

Psychiatry Evaluation and Management Codes

Psychiatrists may use E/M codes to bill for evaluation and management services either alone or with psychotherapy. For psychiatrists and other physicians, psychotherapy is an add-on code to the primary E/M service.

  • 99202 to 99205: Outpatient E/M services for a new patient
  • 99211 to 99215: Outpatient E/M services for an established patient
  • 99241 to 99245: Consultations for a new or established patient in an outpatient setting
  • 99221 to 99223: Initial hospital E/M services for a new or established patient
  • 99231 to 99233: Hospital E/M services for a new or established patient after initial visit
  • 99251 to 99255: Inpatient consultations
  • Common Behavioral Health Case Management CPT Codes

    Like licensed counselors, clinical social workers who provide psychotherapy services use CPT codes to get reimbursed. Here's a CPT description list of frequently used codes, according to the National Association of Social Workers:

    • 90832: 30 minutes of psychotherapy
    • 90834: 45 minutes of psychotherapy
    • 90837: 60 minutes of psychotherapy
    • 90785: Interactive complexity add-on
    • 90839: 60 minutes of psychotherapy for crisis
    • 90840: Each additional 30 minutes of psychotherapy for crisis
    • 90791: Psychiatric diagnostic evaluation
    • 90845: Psychoanalysis
    • 90846: 50 minutes of family psychotherapy without the patient present
    • 90847: 50 minutes of family psychotherapy with the patient present
    • 90853: Group psychotherapy

    Telehealth CPT Medical Coding List

    With an increasing number of behavioral health professionals moving their practices online, it helps to know CPT codes for virtual therapy. Telehealth CPT codes are especially relevant today under the Coronavirus Preparedness and Response Supplemental Appropriations Act, which expands access to Medicare telehealth services.

    According to the Centers for Medicare and Medicaid Services, telehealth visits are the same as in-person visits and get paid at the same rates. Therefore, you will use the identical CPT code for a virtual therapy session as you would if you were billing for a face-to-face meeting. For example, if you meet with a patient online, you would still use the code 90832 for 30 minutes of psychotherapy. However, you would apply different modifiers for telehealth services, as follows.

    • 95 modifier: Add the modifier 95 to the appropriate CPT code. This modifier describes a real-time interaction between a clinician and patient via a telecommunications system, such as through video conferencing. You may also use the modifier GT instead.
    • 02 for place of service: Use Code 02 to describe the place of service (POS) as a telecommunications system. It may replace the commonly used POS code 11, which describes providing therapy in an office.

    As you'll see, some telehealth codes belong to the Healthcare Common Procedural Coding System (HCPCS). HCPCS codes are not part of the CPT set, and they cover specific services and products needed to provide care. HCPCS codes consist of a single letter followed by four numbers. Here are codes you might use specifically for telehealth.

    • G2012: Virtual check-in or brief, patient-initiated visit
    • G2010: Remote evaluation of a recorded video or image provided by an established patient
    • 99421: Online digital evaluation and management service conducted via a patient portal for an established patient, five to 10 minutes of cumulative time over seven days
    • 99422: Online digital evaluation and management service conducted via a patient portal for an established patient, 11 to 20 minutes of cumulative time over seven days
    • 99423: Online digital evaluation and management service conducted via a patient portal for an established patient, 21 or more minutes of cumulative time over seven days

    Non-physician health care professionals may use the codes G2061, G2062, or G2063 to provide an online assessment and management service for an established patient.

    New CPT Codes for Behavioral Health Services

    Every year, health professionals can expect revised or new mental health CPT codes. According to the American Psychological Association, as of Jan. 1, 2020, psychologists must use new therapy CPT codes to get reimbursed for health behavior assessment and intervention services from third-party payers. Providers use these services to address psychological, emotional, cognitive, or behavioral issues that impact the treatment of a physical health problem. Psychologists may provide these services to an individual, group, or a patient's family to help the client cope with physical health conditions.

    HBAI codes require a physical health diagnosis or an ICD code and are not for mental health services. Here are the code revisions.

    • Code 96156 replaces codes 96150 and 96151: Clinicians must now use code 96156 to bill for a health and behavior assessment or reassessment. The new code for assessment services is now event-based rather than time-based.
    • Code 96152 is now 96158 plus 96159: Code 96152 for an individual, face-to-face health behavior intervention is now 96158 for the first 30 minutes. List code 96159 separately for each additional 15 minutes of the intervention.
    • Code 96153 is now 96164 plus 96165: Code 96153 for a face-to-face group health behavior intervention is now 96164 for the first 30 minutes. Tack on the code 96165 for each additional 15 minutes of service.
    • Code 96154 is now 96167 plus 96168: Code 96154 for a face-to-face family health behavior intervention with the patient present is now code 96167 for the first 30 minutes. Use code 96168 for each additional 15 minutes.
    • Code 96155 is now 96170 plus 96171: Code 96155 for a face-to-face family health behavior intervention without the patient present is now 96170 for the first 30 minutes. Use code 96171 for each additional 15 minutes.

    For additional information about the 2021 E/M coding changes, check out our blog post here.

    How CPT Code Changes Impact the Reimbursement Process

    Reimbursement rates change all the time, and a lot depends on the decisions made by the CMS. The CMS accepts the American Medical Association's CPT code recommendations and makes the final decisions regarding code values.

    The code selection process also impacts how much clinicians get paid. For example, with the recent E/M coding changes, clinicians can bill for the total time they spend in one day on an encounter, which includes non-face-to-face time, and gets credit for tasks like interpreting exams performed by other physicians.

    Clinicians can also choose an E/M code based on total time or medical decision-making, selecting the one that makes the most financial sense.

    CPT Code Reimbursement Rates

    Reimbursement rates depend on the insurance payer, location, and practitioner level. For instance, a psychiatrist will receive a higher reimbursement rate than a social worker.

    The CPT code you choose also affects compensation. In general, the longer you spend with a patient delivering services, the more you'll get paid. For example, according to the Mississippi Division of Medicaid's 2020 fee schedule, psychotherapy rates were:

    • 90832: $60.07
    • 90834: $79.90
    • 90837: $119.68

    If you're concerned you're not getting the highest reimbursement rate possible, let us know at ICANotes. We've designed our electronic health record software to help behavioral health specialists maximize reimbursement.

    ICANotes keeps track of documentation elements in clinical notes and automatically calculates the highest-level E/M code supported by a note. ICANotes makes it easy to establish all the required details of accurate E/M documentation by providing pre-templated buttons and an easy-to-use interface. With ICANotes, clinicians can stay up to date on CPT changes and make sure they comply with the Health Insurance Portability and Accountability Act.

    Tips for Maximizing Reimbursement and Avoiding Insurance Claim Denials

    If you hope to avoid issues with claims, you mostly want to remember that medical necessity determines the level of service to bill. It would not be appropriate to document a higher level of service if it is unnecessary. Always make sure the documentation supports the level of care you are billing. Here are a few more tips to keep in mind.

     

    1. Ensure Correct Coding

    To receive reimbursement, a clinician must complete accurate coding. Coding errors can lead to payment delays or rejected claims. Frequent or consistent errors could lead to an audit or charges of fraud. Strive for the highest accuracy, and cut down on simple errors like incorrect patient information or policy number mistakes. Always refer to the AMA’s most recent CPT manual to make sure you use the right codes in your practice.

    Also, make it a habit to check and recheck work, and thoroughly read all the therapy notes included with the codes. Encourage staff members to do the same. One of the most common causes of claim denials is the improper use of modifiers. Therefore, make sure to familiarize yourself with modifiers before using them. Modifiers can be the difference between maximum reimbursement and reduced reimbursement, so it's crucial to review the rules.

    2. Claim Only What’s Medically Necessary

    Medicare and other payers define what's medically necessary for different ways, but in general, it's about doing what's best for the patient at the right time. A claim for a service that is not a medical necessity will likely get denied.

    To help demonstrate a medically necessary claim, make sure to choose the appropriate ICD code and link it to the associated CPT codes that are valid for the visit. Doing so enables staff and insurance payers to see the reason for each service.

    3. File Claims on Time

    You must submit claims by a specific deadline. For example, Medicare requires you to file no later than 12 months after the date of service. These dates can vary depending on the payer, and some claims may be due within 90 days or 180 days after service. By meeting deadlines, you'll ensure you receive adequate reimbursement.

    4. Emphasize Quality Documentation

    Inadequate documentation can affect the reimbursement process. Make sure everyone in your practice understands the value of correct, legible, and complete documentation. Otherwise, it will be challenging to make an accurate or complete claim.

    5. Identify and Educate

    Identify coding errors, review past mistakes, and aim to correct the errors by educating staff and staying current on any code changes. Schedule regular training meetings to keep information fresh and share any updates.

    Use ICANotes for Fast and Accurate Billing

    Proper coding requires knowledge and practice. Most behavioral health clinicians want to spend their time and energy providing patient care — not worrying about coding and claims. ICANotes can step in and take care of the work for you, so you can get back to doing what you love.

    With ICANotes, you can expect automatic coding at the highest reimbursement level possible to ensure claims get accepted and you get paid. Without the need to fix errors or resubmit claims, you’ll save time, money, and energy. To experience the benefits of ICANotes behavioral health EHR software firsthand, sign up for a free trial today!

    SCHEDULE A DEMO

    Sources:

    1. https://www.cdc.gov/wtc/pdfs/policies/cms-1500-P.pdf
    2. https://www.icanotes.com/2021/01/15/what-to-know-new-e-m-coding-changes/
    3. https://www.psychiatry.org/psychiatrists/practice/practice-management/coding-reimbursement-medicare-and-medicaid/coding-and-reimbursement
    4. https://www.apaservices. org/practice/reimbursement/health-codes/psychotherapy
    5. https://www.aapc.com/resources/medical-coding/cpt.aspx
    6. https://en.wikipedia.org/wiki/Current_Procedural_Terminology
    7. https://psychcentral.com/lib/cpt-codes-for-psychology-services#3
    8. https://www.cms.gov/files/document/medicare-mental-health.pdf
    9. https://blog.therapynotes.com/understanding-crisis-codes-90839-and-90840
    10. https://therathink.com/cpt-code-90839/
    11. https://www.aappublications.org/news/2017/06/21/Coding062117
    12. https://www.aacap.org/App_Themes/AACAP/Docs/member_resources/aacap_news/2018/AACAP-News-May-June-2018-CPT-Screening-Codes.pdf
    13. https://www.aap.org/en-us/Documents/coding_factsheet_developmentalscreeningtestingandEmotionalBehvioraassessment.pdf
    14. https://www.apaservices.org/practice/reimbursement/health-codes/testing/neuropsychological-testing.pdf
    15. https://www.asha.org/practice/reimbursement/medicare/slp_coding_rules/
    16. https://www.apaservices. org/practice/reimbursement/health-codes/testing/webinar.pdf
    17. https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/eval-mgmt-serv-guide-icn006764.pdf
    18. https://www.facs.org/-/media/files/advocacy/practice-management/2020_emcoding.ashx
    19. https://www.medscape.com/courses/section/880390
    20. https://www.apaservices.org/practice/reimbursement/health-codes/crosswalk.pdf
    21. https://www.apaservices.org/practice/reimbursement/health-codes/testing/codes-descriptions.pdf
    22. https://www.apaservices.org/practice/reimbursement/health-codes/reminder-new-codes
    23. https://www.apaservices.org/practice/reimbursement/government/psychotherapy-services
    24. https://therathink.com/insurance-reimbursement-rates-for-psychotherapy/
    25. https://medicaid.ms.gov/wp-content/uploads/2014/03/CommunityMentalHealthCenter.pdf
    26. https://www.medicaleconomics.com/view/e-m-changes-take-effect-january-2021

    October Boyles, MSN, BSN, RN

    Clinical Director October has been a Registered Nurse for over 15 years. She is board certified in Mental Health and Psychiatric Nursing. She holds a Bachelor of Arts from the University of North Carolina at Greensboro. She also graduated with bachelor and master degrees in Nursing from Western Governors University.

    Top CPT Codes for Mental Health Billing – My Clients Plus

    While precision in how you use CPT codes may not seem of utmost significance, in fact, using the correct CPT codes for the mental health services you provide is important for two major reasons. When your claims include the right codes, they’ll be accepted in a more timely manner, ensuring you have the necessary cash flow to operate your practice. Perhaps more urgently, coding mistakes could cause your practice to be audited, and errors could result in fines. In this post, we’ll cover what you need to know about using CPT codes and the most common codes you should become familiar with.

    What are CPT Codes for Mental Health?

    The Current Procedural Terminology (CPT) code set describes tests, evaluations, treatments, and other medical procedures used in the spectrum of healthcare. The set contains over 8,000 codes and is published and updated annually by the American Medical Association. It was created to track healthcare trends and issues as well to use in the claims submission process. The codes communicate to payers what procedures you need to be reimbursed for as a provider. 

    The codes related to mental health (codes 90785-90899) are found in the Psychiatry section of the CPT code set and cover services provided by medical professionals, such as psychiatrists, as well as services that can be delivered by non-medical professionals such as licensed clinical psychologists, licensed professional counselors, licensed marriage and family therapists, and licensed clinical social workers. 

    Categories of Mental Health CPT Codes

    The mental health CPT codes used by therapists are organized into four distinct categories. These categories make it easier to find the code you’re looking for. 

    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

    Group Psychotherapy

    • 90853: Group psychotherapy (other than a multiple-family group)
    • 90857: Interactive group psychotherapy

    Common Mental Health CPT Codes

    While there are many codes that may be applicable to mental health services more broadly, in a therapy setting, you’ll probably find yourself using only a relatively small subset of these codes. Learning the most common CPT codes for mental health will help you choose the best code for each service you provide. Here are the most common codes that you’ll encounter as a therapist.

    90837 — Psychotherapy, 60 minutes 

    Description: Individual psychotherapy, 60 minutes, with client and/or family member.

    Time: 60 minutes (functionally between 53 and 60 minutes)

    90834 — Psychotherapy, 45 minutes

    Description: Individual psychotherapy, 45 minutes, with client and/or family member.

    Time: 45 minutes (functionally between 38 and 52 minutes)

    90791 — Psychiatric diagnostic evaluation without medical services

    Description: Initial diagnostic interview exam that does not include any medical services. Includes a chief complaint, history of present illness, family and psychosocial history, and complete mental status examination. (Use code 90792 for an initial evaluation with medical services.)

    Time: Not time-based

    90847 — Family psychotherapy (with client present), 50 minutes

    Description: Family psychotherapy (conjoint psychotherapy) (with client present). (Can also be used for couples therapy.)

    Time: 50 minutes

    90853 — Group psychotherapy (other than of a multiple-family group)

    Description: Group psychotherapy (other than of a multiple-family group). Relies on the use of interactions of group members to examine the pathology of each individual within the group. The dynamics of the entire group are noted and used to modify behaviors and attitudes of the client members. (Used to report per-session services for each group member.)

    Time: Not time-based

    90846 – Family psychotherapy (without client present), 50 minutes

    Description: Therapy session intended to aid the treatment of the client, where the family of a client is present without the client being present. 

    Time: 50 minutes

    90875 – Under other psychiatric services or procedures

    Description: Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the client), with psychotherapy (e. g., insight-oriented, behavior modifying, or supportive psychotherapy).

    Time: 20-30 minutes

    90832 – Psychotherapy, 30 minutes

    Description: Individual psychotherapy, 30 minutes

    Time: 30 minutes (functionally between 16 – 37 mins)

    90838 – Psychotherapy, 60 minutes, with E/M service

    Description: Individual psychotherapy, 60 minutes with client and/or family member when performed with an evaluation and management (E/M) service.

    Time: 60 minutes (functionally between 53 and 60 minutes)

    99404 — Under preventive medicine, individual counseling services

    Description: Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure)

    Time: 60 minutes (functionally between 53 and 60 minutes)

    CPT Code Modifiers

    Code modifiers provide additional information to a payer. Modifiers can describe the license level of provider, when services were provided, and how the services were provided, among other things. Here are four modifiers that you may encounter.

    • Modifier 25 — Typically, a single code will accurately describe a session. But occasionally, you may find that a fully separate E/M service is needed (performed by the same provider) on the same day. Modifier 25 is used in these situations, as it calls out that service as separate and reimbursable. Note that you can only attach modifier 25 to codes 99201-99215, 99341-99350.
    • Modifier 59 — Similar to modifier 25, this modifier is used to describe a distinct non-E/M procedural service done on the same day. Note that your documentation must support a separate session. 
    • Modifier GT — Used for telehealth sessions involving interactive audio and video.
    • Modifier UT — Used when the provider sees a patient in crisis.

    When you understand how CPT codes work and have a firm knowledge of the codes you’ll use most often in your therapy practice, you’ll increase your claims submission rate and reduce the likelihood of being flagged for inappropriate coding. Beyond the practicality of improving cash flow, accurate coding delivers peace of mind since you won’t have to worry about whether or not you’re using CPT codes correctly.

    Moscow Branch of the Russian Society of Psychiatrists

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  • Types of payment documents: incorrect details

    Contents

    • Payment documents and their execution
      • Types of payment documents
      • New registration rules
    • Types of payment documents
    • incorrect details for the international transfer
    • Code 9090 in customs declaration
      • Classifier Customs
    • Customs will issue a receipt in electronic form
    • Runals of the FCS RUSS

    Payment documents and their execution

    To pass customs control, a certain list of documents is required. This list includes payment documents. Payment documents confirm information about the customs value, payment of duties and other payments. nine0003

    Payment documents are tied to customs declarations.

    Types of payment documents

    For customs clearance you will need the following payment documents:

    • invoice;
    • bank payment papers;
    • cost estimate in which the price of transportation is indicated;
    • quotations of world stock exchanges will be needed when importing stock products;
    • bank payment papers relating to payment for intermediary services;
    • nine0062 papers indicating the amount of funds that the seller will receive as a result of the disposal of products;
    • payment papers concerning the price of packaging materials;
    • papers from credit companies (if currency transactions were made during transportation), bank statements;
    • papers evidencing entitlement to tariffs or tax relief. For example, these can be documents on humanitarian aid;
    • payment papers, which testify to the payment of customs duties. Payment orders, on which there should be a mark from a banking institution on execution; nine0063
    • papers certifying the payment of customs duties and taxes.

    This is only an indicative list of required payment documents. The exact list depends on the individual situation: the type of product, the conditions of its transportation, its origin, the number of commercial transactions carried out with the product.

    The form of the payment document must contain the details of the organization, the total amount of the transaction and the balance of funds.

    New registration rules

    Recently, the rules for filling out payment customs documents have been edited, and now it is their new version that should be followed. The biggest changes were made to the paragraph concerning the procedure for specifying the data identifying the payment. nine0003

    First of all, the list of persons who are required to comply with these rules has changed. Now they also include territorial branches of the FSSP, OFK, credit companies and their regional branches, federal postal companies, and various organizations.

    Payment papers, from now on, are filled in according to separate rules, not related to taxation rules. Customs payment codes have been introduced that are independent of taxation codes. Now the following codes are entered on line 106:

    • DE. Declaration for customs;
    • software. Receipt order;
    • KV. Receipt in the presence of penalties;
    • CT. Cost adjustment for customs clearance and payments for customs;
    • ID. executive paper;
    • IP. collection order;
    • TU. Requiring payment of fees for customs;
    • DB. Documentary package of customs accounting services;
    • ID. Collection paper;
    • KP. Agreement on the interaction of large payers in the payment of total payments. nine0063

    The completion of line 108 depends on the intended document. For example, these may be the last digits of the customs declaration, the number of the enforcement paper.

    When you specify a paper number, the sign of the number is not required.

    Separate codes are also entered in line 110:

    • pcs. Payment of the penalty fee;
    • ZD. Payment on account of existing debt;
    • PE. Payment of a penalty;
    • TP. current payment.
    • nine0068

      When processing payment documents, now line 104 is not filled with zeros, as it was before.

      Financial documents testify to the financial condition of the company. Each participant in foreign economic activity must clearly navigate these papers.
      Rules for completing the transit declaration form . This document will be needed when opening the customs transit procedure within the country.

      Line 101 indicates the status of the organization. Changes were also introduced here to more accurately identify the purpose of the transferred amounts of money in the state budget. If earlier there were 15 codes, now they are expanded to 20 (01-20). nine0003

      1. YL. The legal entity paying the fees.
      2. Tax officer (agent).
      3. Organization of the federal postal service, directly issued a payment document required for payment of various payments from foreign economic activity for individuals;
      4. Tax organization.
      5. Bodies of the Federal Bailiff Service.
      6. legal entity that has concluded a foreign economic agreement.
      7. Customs organization.
      8. Payer of other payments to the public sector of the Russian Federation (except for tax payments). nine0063
      9. IP. Sole proprietor who pays fees or charges.
      10. Notary specializing in private practice.
      11. Lawyer who founded a law office.
      12. Chairman of farms.
      13. Client of a banking institution.
      14. Taxpayer making payments to FL (individuals).
      15. A credit company that opened settlement documents for various payments made by individuals, for which it is not necessary to open a bank account. nine0063
      16. FL (individual), engaged in foreign economic activity.
      17. individual entrepreneur engaged in foreign economic activity.
      18. Payer (not declarant) who pays customs fees.
      19. Companies that have opened a settlement document for transferring money confiscated from the debtor to the OFC account to pay customs duties.
      20. Credit companies that have opened a settlement paper for payments by an individual to transfer customs payments that are paid without the need to open a bank account. nine0063

      Now the status for foreign economic activity participants is divided into individual entrepreneurs and legal entities.

      When filling out payment documents, you must follow the latest version of the rules. The exact list of payment documents required for transfer to the customs authority depends on individual conditions: type of transportation, type of goods, and so on.

      For more information on the subject, see the "Documents" section.

      Free consultation by phone:

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      Attention! Due to recent changes in legislation, the legal information in this article may be out of date!

      Our specialist will advise you free of charge.

      Types of payment documents

      Types of payment documents:

      • 1. Payment request;
      • 2. Payment order;
      • 3. Payment request-order;
      • nine0062 4. Check;
      • 5. Letter of credit;
      • 6. Promissory note;

      A payment request is a settlement document containing a demand from the supplier (shipper) and other recipients of funds to the payer to pay a certain amount through the bank by way of collection.

      Advantages:

      • 1. The collection system provides a clear procedure for addressing the delivery of claims and control over settlements on the part of the buyer and supplier;
      • 2. Shipment without advance payment can be carried out. nine0063

      Disadvantages:

      1. Emergence of mutual receivables and payables.

      A payment order is an order from an enterprise to a servicing bank to transfer a certain amount from its account to another enterprise's account in the same or another bank.

      Advantages of this form of payment:

      • 1. Versatility.
      • 2. You can bring the shipping date closer to the payment date.
      • 3. Ease of registration and passing through the bank. nine0063

      Disadvantages of this form of payment:

      • 1. There is no proper payment guarantee.
      • 2. The emergence of mutual receivables and payables.

      A payment request-order is a payment document used for non-cash payments, which is a supplier's requirement to the buyer to pay (on the basis of settlement and shipping documents sent to the payer's servicing bank) the cost of products, work performed, services rendered. nine0003

      Advantages of this form of payment: simplification of workflow and cost reduction; increased responsibility for supplier and payer settlements. Disadvantages: there is no proper guarantee of payment and the occurrence of mutual debt.

      A check is an unconditional written offer by the drawer to the payer to pay the amount indicated on the check to the holder of the check.

      The main advantage of settlements by checks is the guarantee of payment, the main disadvantage is the complexity of the document flow, since funds are credited to the supplier (check holder) not at the time of presentation of checks to your bank, but only after they are debited from the account of the payer (drawer). nine0003

      A letter of credit is an instruction from the buyer's bank to a nonresident bank of the supplier, issued by it on behalf of the client to make a payment to the supplier, provided that the latter provides documents confirming the shipment of goods, the provision of services, the performance of work stipulated in the letter of credit and other conditions of the letter of credit.

      Advantages of this form of non-cash payments: guarantee of payment to the supplier; control over the fulfillment of the terms of delivery and the terms of the letter of credit by banks. Disadvantages: complicated workflow; funds are diverted from economic turnover. nine0003

      A bill is a security that certifies the unconditional obligation of the drawer to pay the amount specified in it to the holder (owner of the bill) upon maturity.

      Incorrect details for an international transfer

      Yesterday, through a long conversation with representatives of the bank (deputy head of Subsidiary 8 branch 7806 VTB24), we found out that a ruble transfer from a foreign bank to a ruble account is basically impossible, because (I quote) from VTB24 now there are no ruble correspondent accounts in foreign banks.” So what you wrote here is nonsense. nine0019 It is pointless to contact the sender of the payment - the payment was returned to him, with the payment details filled in correctly. And this, dear bank, tells me how you work with clients: the right hand does not know what the left is doing. And issues are resolved only through personal communication with the heads of individual departments.
      In addition, the bank's employees claim that for a transfer from a foreign bank in rubles, the bank's SWIFT is not needed. And you can't point it out. And foreign banks require the mandatory indication of SWIFT. The exception is Latvian and Lithuanian banks that have correspondent accounts in the Russian Federation. They can instruct the correspondent bank to transfer funds within the country. And at the moment, the only way to make a ruble transfer to VTB24 from abroad is to use the services of such a bank. nine0019 And I am categorically dissatisfied with your answer and insist on conducting an internal investigation of this incident with the involvement of the following bank employees: payment for these details will be processed.
      cashier manager Elena (last name unknown), in response to my appeal to the bank with a copy of the payment order from the sender, who assured me that the payment for these details should reach, and inquired with the branch controller about the accuracy of filling in the details; nine0019 The head of the customer service department, whose employees claim that using the details for ruble accounts indicated on the bank's website, it is possible to make a transfer in rubles from a foreign bank, thereby misleading the bank's customers;
      and involving the following documents in the investigation:
      application for opening a bank account of an individual 408 **** 9 dated 06/13/2017;
      of the copy of the payment order from the sending bank dated 06/19/2017 that I provided to the bank earlier; nine0019 archive of correspondence with bank employees (emails and chat correspondence in the VTB24 app for iOS).

      >Systematization of accounting

      05/17/2018 | No comments

      Code 9090 in the customs declaration

      Customs payment classifier

    Annex 10 to the Instructions on the procedure for filling out a cargo customs declaration registered by the Ministry of Justice on November 3, 1999 No. 834

    This Classifier in accordance with
    State Customs Committee Resolution registered by the Ministry of Justice on February 19, 2008 No. 834-16

    Customs legislation

    Directory entries: 34

    Code

    Name of payment type

    1. Customs fees for customs clearance

    nine0392

    Customs fees for customs clearance of goods

    Customs fees for customs clearance of goods in transit

    Customs fees for customs clearance of goods outside designated places and/or outside the working hours of customs authorities

    Customs fees for customs clearance of goods in the territory of free customs zones and free warehouses. nine0019 (The code was introduced in accordance with the Decree of the State Customs Committee, registered by the Ministry of Justice on July 16, 2003 No. 834-10)

    2. Customs duties and taxes collected by the customs authorities

    Import customs duty

    Export customs duty

    Import excise duty

    Export tax

    Value added tax

    Paragraph 3 has become invalid in accordance with the Resolution of the State Customs Committee, registered by the Ministry of Justice on February 19, 2008 No. 834-16

    3. Payments collected from individuals

    Fee on goods imported by individuals

    Single customs payment for individuals
    (Code entered in accordance with the Decree of the State Customs Committee, registered by the Ministry of Justice on May 27, 2002 No. 834-5)

    4. Other fees

    Customs fees for storage of goods in a customs warehouse owned by the customs authority

    Customs fees for customs escort of goods transported by all modes of transport through the territory of the Republic of Uzbekistan

    Customs fees for the issuance of a license

    Other customs fees provided for by the legislation of the Republic of Uzbekistan

    5. Boards

    Advance decision fee

    6. Funds and fines

    Proceeds from the sale of confiscated items

    Proceeds from the sale of collateral

    nine0395

    Fines

    7. Other customs payments

    Interest for deferment of customs payment

    Interest for the provision of installment payment of customs payment

    Penya

    Code 73 has become invalid in accordance with the Decree of the State Customs Committee, registered by the Ministry of Justice 19.02.2008 No. 834-16

    Fee for legal entities for the import of non-food consumer goods (Code introduced in accordance with the Decree of the State Customs Committee, registered by the Ministry of Justice on July 30, 2002 No. 834-6)

    Codes 73 and 74 should be considered codes 74 and 75 in accordance with the Resolution of the State Customs Committee, registered by the Ministry of Justice on July 30, 2002 No. 834-6

    Other types of customs payments, the collection of which is entrusted to the customs authorities

    Amount of security for payment of customs payments

    Duty on the import of non-food consumer goods produced in third countries and re-exported for commercial activities by legal entities and individuals from the territory of neighboring states (Code introduced in accordance with the Resolution of the State Customs Committee, registered by the Ministry of Justice on 01.02.2003 No. 834-7)

    8. Special customs duties
    (Item was introduced in accordance with the Decree of the State Customs Committee, registered by the Ministry of Justice on July 5, 2007 No. 834-13)

    Special duty

    Temporary special duty

    Anti-dumping duty

    Temporary anti-dumping duty

    Countervailing duty

    nine0395

    Temporary countervailing duty

    nine0698 note
    Code Description Payment code to the budget
    1010 Customs fees for customs operations (for customs clearance of goods, for customs declaration of goods, for customs operations) In addition to customs fees for customs operations levied in the Republic of Belarus in respect of goods for personal use. 02202
    1020 Customs fees for customs escort
    1040 Customs fees for issuing a qualification certificate of a specialist in the field of customs (specialist in customs operations, specialist in customs clearance)
    1050 Customs fees for making a preliminary decision by the customs authority
    1060 Customs fees for inclusion in the register of banks and non-bank financial institutions recognized by the customs authorities as a guarantor of payment of customs duties and taxes
    1070 Customs fees for customs operations collected when individuals move goods for personal use subject to customs duties and taxes 02204
    2010 Import customs duty (other duties, taxes and fees having equivalent effect), the obligation to pay which arose from September 1, 2010 02601
    2020 Import customs duty, the obligation to pay which arose before September 1, 2010
    2040 Special duty established in accordance with the Protocol on the application of special protective, anti-dumping and countervailing measures in relation to third countries (Appendix No. 8 to the Treaty on the Eurasian Economic Union of May 29, 2014) 02701
    2050 Anti-dumping duty established in accordance with the Protocol on the application of special protective, anti-dumping and compensatory measures in relation to third countries (Appendix No. 8 to the Treaty on the Eurasian Economic Union of 29May 2014) 02701
    2060 Countervailing duty established in accordance with the Protocol on the application of special protective, anti-dumping and countervailing measures in relation to third countries (Appendix No. 8 to the Treaty on the Eurasian Economic Union of May 29, 2014) 02701
    2110 Trigger safeguard measure applied in accordance with the Free Trade Agreement between the Eurasian Economic Union and its Member States, on the one hand, and the Socialist Republic of Vietnam, on the other hand, dated 29May 2015
    2140 Provisional special duty
    2150 Provisional anti-dumping duty
    2160 Provisional countervailing duty
    2240 Special fee payable in accordance with the procedure established for the collection of the relevant provisional types of fees 03116
    2250 Anti-dumping duty payable in accordance with the procedure established for the collection of relevant provisional types of duties 03116
    2260 Countervailing duty payable in accordance with the procedure established for the collection of the relevant preliminary types of duties 03116
    3010 Export customs duty on goods for which a separate code for the type of export customs duty is not established 9039five 02309
    3050 Export customs duty on potash fertilizers
    3800 Export customs duty calculated and paid in US dollars when placed under the customs procedure for the export of crude oil, the country of origin of which is not the Republic of Belarus, and certain categories of goods produced from oil
    3810 Export customs duty on the export of crude oil, the country of origin of which is the Republic of Belarus
    4180 Excises, on alcoholic products and alcohol-containing solutions 01418
    4190 Excises on beer 01419
    4200 Excises on tobacco products 01420
    4220 Excises on motor vehicles and other motor fuels 01422
    4230 Excises on motor oils 01423
    5010 Value added tax Other than value added tax levied in the Republic of Kazakhstan; 01002
    6010 Customs duties, taxes at uniform rates on goods for personal use 02201
    6020 Total customs payment for goods for personal use
    9120 Utilization fee, the payer of which is an individual who is not an individual entrepreneur
    9130 Utilization fee, the payer of which is a legal entity or an individual entrepreneur 02013
    9200 Ensuring the fulfillment of the obligation to pay customs duties, taxes, special, anti-dumping, countervailing duties (except for ensuring the fulfillment of the obligations of a legal entity carrying out activities in the field of customs) 03112
    9910 Ensuring the fulfillment of obligations of a legal entity carrying out activities in the field of customs

    Customs will issue a receipt in electronic form

    From September 21, 2017, the customs authorities will start issuing customs receipts in electronic form. Information about their issuance will be available in the "Personal Account of a Foreign Economic Activity Participant" on the website of the Federal Customs Service of Russia.

    On this day, the order of the Ministry of Finance of Russia dated 9June 2017 No. 86n “On Approval of the Form of a Customs Receipt, the Procedure for Filling in and Using a Customs Receipt, as well as the Procedure for Informing Payers of Customs Duties, Taxes and (or) Other Persons Who Provided Security for the Payment of Customs Duties and Taxes, on the Issuance of a Customs Receipt”. This document provides for the execution of a customs receipt in the form of an electronic document.

    The simplification of the application of customs receipts will be noticed by a wide range of persons carrying out the movement of goods across the customs border, since the security is provided by both organizations and individuals. For 8 months of 2017, more than 75 thousand customs receipts were issued. A customs receipt is used when accepting a security for the payment of customs payments during an additional verification of information about a product, transportation of goods, conditional release, and in a number of other cases. nine0003

    The innovation will reduce the time for acceptance of security and the formation of a customs receipt, as well as reduce the costs of participants in foreign economic activity. Now the payer will not need to come to the customs post to receive a customs receipt, but at his request, the customs post can generate a copy of the customs receipt on paper.

    When converting a customs receipt into electronic form, the form of this document is also simplified and an automated procedure for transferring electronic information about the customs receipt to the payer is provided. nine0003

    Participants of foreign economic activity will be able to obtain such information in their “Personal account of a foreign economic activity participant”, which can be accessed through the official website of the Federal Customs Service of Russia (customs.ru).

    Our reference:

    The customs receipt has been applied for more than 13 years. Registration of a customs receipt is carried out using special forms with different degrees of protection.


    Learn more