Psychiatry CPT Codes are numerous and nuanced.  This guide will teach you the most common psychiatry CPT codes, psychiatry addon codes, psychiatry evaluation and management codes, and how to bill psychiatry CPT codes.

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There are quite a few medical billing CPT codes for Psychiatry services and psychiatrists to use, some reimbursed more often or at higher rates than others.

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We at TheraThink provide a billing service that can help de-code which psychiatry CPT codes to use.  This guide will also help you find out which codes to pick.

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We will offer you a quick guide on most common psychiatry CPT Codes, explain evaluation and management (E/m) codes, and then provide an exhaustive list of all Psychiatry CPT codes.
 

Common Psychiatric CPT Codes

Make sure to review our list of the most common insurance billing procedure codes for psych
services:

Diagnostic, Evaluation,
Intake CPT Code:

• 90791 – Psychiatric Diagnostic
  Evaluation without medical services
  usually just one/client is covered)

• 90792 – Psychiatric Diagnostic
  Evaluation with medical services
   

Outpatient Mental Health
CPT Codes:

• 90832 – Psychotherapy, 30
  minutes (16-37 minutes).

• 90834 – Psychotherapy, 45
  minutes (38-52 minutes).

• 90837 – Psychotherapy, 60
  minutes (53 minutes and over).

• 90846 – Family or couples
  psychotherapy, without patient present.

• 90847 – Family or couples
  psychotherapy, with patient present.

• 90839 – Psychotherapy for crisis,60 minutes (30-74 minutes).

• +90840 – Add-on code for an additional
  30 minutes (75 minutes and over).
  Used in conjunction with 90839.
   

Psychotherapy CPT Codes with Evaluation & Management Services:

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• 90833 – Evaluation and Management with 30 Minutes Psychotherapy

• 90836 – Evaluation and Management with 45 Minutes Psychotherapy

• 90838 – Evaluation and Management with 60 Minutes Psychotherapy

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Psychiatry CPT Code Cheat Cheat PDF

 

Here is a downloadable Psychiatry CPT Code Cheat Sheet PDF:

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Psychiatry CPT Code Cheat Sheet PDF

 

Or in image format:

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Download Part 1

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Download Part 2

 

 

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If you need help choose the right CPT code to use for your insurance claims, we help translate billing into English with our mental health billing service.

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Evaluation and Management Psychiatric CPT Codes

 

This chart helps better visualize the CPT codes by time.  This is not an exhaustive look into which E/M codes to use; please refer to our documentation and guidelines section later in this article.

Here is a list of the most common evaluation and management psychiatry CPT codes:

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• New Patient, Outpatient, In-Office Services CPT Codes:

  • 99201 – 10 Minutes

  • 99202 – 20 Minutes

  • 99203 – 30 Minutes

  • 99204 – 45 Minutes

  • 99205 – 60 Minutes

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• Established Patient, Outpatient,
  In-Office Services CPT Codes:

  • 99211 – 5 Minutes

  • 99212 – 10 Minutes

  • 99213 – 15 Minutes

  • 99214 – 25 Minutes

  • 99215 – 40 Minutes

• New or Established Patient,
  Outpatient, Consultation CPT Codes:

  • 99241 – 15 Minutes

  • 99242 – 30 Minutes

  • 99243 – 40 Minutes

  • 99244 – 60 Minutes

  • 99245 – 90 Minutes

• Inpatient Consultation CPT Codes:

  • 99251 – 20 Minutes

  • 99252 – 40 Minutes

  • 99253 – 55 Minutes

  • 99254 – 80 Minutes

  • 99255 – 110 Minutes
     

Reimbursement Rates for Psychiatrists

Please check out our extensive guide to 2021 reimbursement rates for psychiatrists.
 

Psychiatry CPT Codes List

CPT CODEDESCRIPTION

90791Psychiatric Diagnostic Evaluation without medical services

90792Psychiatric Diagnostic Evaluation with medical services

90865Narcosynthesis

90867Therapeutic repetitive transcranial magnetic stimulation (TMS); initial

90868Therapeutic repetitive transcranial magnetic stimulation (TMS); subsequent

90869Therapeutic repetitive transcranial magnetic stimulation (TMS); subsequent motor threshold re-determination with delivery and management

90870Electroconvulsive therapy (ECT)

90875Individual psychophysiological therapy incorporating biofeedback training, 30 minutes

90876Individual psychophysiological therapy incorporating biofeedback, 45 minutes

90880Hypnotherapy

90882Environmental manipulation

90885Psychiatric evaluation of records

90887Interpretation or explanation to family

90889Preparation of psychiatric report

90899Unlisted psychiatric service or procedure

90901Biofeedback training by any modality

90911Biofeedback training, including EMG and/or manometry

99201E/M – New Patient Office Visit – 10 Minutes

99202E/M – New Patient Office Visit – 20 Minutes

99203E/M – New Patient Office Visit – 30 Minutes

99204E/M – New Patient Office Visit – 45 Minutes

99205E/M – New Patient Office Visit – 60 Minutes

99211E/M – Established Patients – 5 Minutes

99212E/M – Established Patients – 10 Minutes

99213E/M – Established Patients – 15 Minutes

99214E/M – Established Patients – 25 Minutes

99215E/M – Established Patients – 40 Minutes

99443Telephone therapy (psychiatrist), – limit 3 units/hours per application

90833Psychotherapy, 30 minutes, with E/M service (90833)

90836Psychotherapy, 45 minutes, with E/M service (90836)

90838Psychotherapy, 60 minutes, with E/M service (90838)

90832Psychotherapy, 30 minutes (90832)

90834Psychotherapy, 45 minutes (90834)

90837Psychotherapy, 60 minutes (90837)

9611896118 Neuropsychological testing by psychologist or physician

9610196101 Psychological testing by psychologist or physician

99441Telephone E/M service provided to an established patient, parent/guardian, 5-10 minutes

99442Telephone E/M service provided to an established patient, parent/guardian, 11-20 minutes

99443Telephone E/M service provided to an established patient, parent/guardian, 21-30 minutes

Addon CodesDescription

9935430 to 74 minutes, Prolonged Services With Direct Patient Contact Code Time beyond the time (90837) or typical time (E/M codes) of the primary service

9935575 to 104 minutes, Prolonged Services With Direct Patient Contact Code Time beyond the time (90837) or typical time (E/M codes) of the primary service

99355additional 99355 each additional increment up to 30 minutes

9935830 to 74 minutes, Prolonged Services Without Direct Patient Contact

99359additional increment up to 30 minutes, Prolonged Services Without Direct Patient Contact

It’s extremely important to note that many of these codes will not be covered by a client’s insurance policy, may require authorization, or may have specific modifiers required depending on how services are rendered.
 

If you don’t want to manage any of this work, we’re happy to help do the insurance billing for your psychiatry practice.
 

Extended Session Add-On CPT Codes for Psychiatric Services

E/M CPT CODEADD-ON CPT CODEMEDICARE 2020 CPT CODE REIMBURSEMENT:DESCRIPTION OF SERVICES

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9079190833$72.9030 minutes, Psychotherapy provided alongside evaluation and management services.

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9079190836$92.3945 minutes, Psychotherapy provided alongside evaluation and management services.

99205

 

9921599415$10.1145-74 minutes, evaluation and management services

99205
9921599415
99416$4.3375-104 minutes, evaluation and management services
 

Psychiatry CPT Code Modifiers

Here is a short list of the most common CPT Code modifiers that would be used while rending psychiatric services.

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CPT Code Modifier 22
 

• Unusual Procedure Services

This modifier is used when the work associated with the service provided is greater than that usually required for the listed code.
 

CPT Code Modifier 25

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• Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service

This modifier is used to indicate that on the day a procedure or service identified by a CPT code was performed, the patient’s condition required a significant, separately identifiable E/M service above and beyond the other service provided or beyond the usual pre- and postoperative care associated with the procedure performed.

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CPT Code Modifier 26

• Professional Component

This modifier is used for procedures that are a combination of a physician component and a technical component.

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When the physician component is reported separately, this modifier is added to the usual procedure.

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CPT Code Modifier 52

• Reduced Services

This modifier is used to report a service that is reduced in time.

Source
 

Setting & Documentation Guidelines for Psychiatric Services

 

These services are typically set in an office location.

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Please review the Medicare guidelines for E/M guidelines and documentation for exhaustive detail:

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https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/eval-mgmt-serv-guide-ICN006764.pdf

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Unusual Psychiatry CPT Code Descriptions

These descriptions are directly copied from the American Psychiatric Association’s coding pamphlet.

Please refer to their documentation

here: https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Practice-Management/Coding-Reimbursement-Medicare-Medicaid/Coding-Reimbursement/cpt-primer-for-psychiatrists.pdf

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These services are often not reimbursed by insurance companies.  Call their insurance plan to obtain authorization or have a mental health billing service like ours help.

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CPT Code 90865

 

Narcosynthesis for Psychiatric Diagnostic and Therapeutic Purposes (e.g. sodium amobarbital (Amytal) interview)

This procedure involves the administration, usually through slow intravenous infusion, of a barbiturate or a benzodiazepine in order to suppress inhibitions, allowing the patient to reveal and discuss material that cannot be verbalized without the disinhibiting effect of the medication. This code is reimbursed by most insurers.

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CPT Code 90867

 

Therapeutic Repetitive Transcranial Magnetic Stimulation (TMS) initial treatment, including cortical mapping, motor threshold determination, delivery and management

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CPT Code 90868

 

Subsequent TMS Delivery and Management, per session

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CPT Code 90869

 

Subsequent TMS Motor Threshold Re-Determination with Delivery and Management

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CPT Code 90870

 

Electroconvulsive Therapy (Includes Necessary Monitoring); Single seizure

This code is for electroconvulsive therapy (ECT), which involves the application of electric current to the patient’s brain for the purposes of producing a seizure or series of seizures to alleviate mental symptoms. ECT is used primarily for the treatment of depression that does not respond to medication.

The code includes the time the physician takes to monitor the patient during the convulsive phase and during the recovery phase. When the psychiatrist also administers the anesthesia for ECT, the anesthesia service should be reported separately, using an anesthesia code. ECT is covered by most insurance plans.

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CPT Code 90875

 

Individual Psychophysiological Therapy Incorporating Biofeedback

Training by any Modality (face-to-face with the patient), With Psychotherapy (e.g., insight-oriented, behavior modifying, or supportive psychotherapy); approximately 20-30 minutes and,

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CPT Code 90876

 

approximately 45-50 minutes

These two procedures incorporate biofeedback and psychotherapy (insight oriented, behavior modifying, or supportive) as combined modalities conducted face-to-face with the patient.

They are distinct from biofeedback codes 90901 and 90911, which do not incorporate psychotherapy and do not require face-to-face time. Medicare will not reimburse for either of these codes

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CPT Code 90880

 

Hypnotherapy

 

Hypnosis is the procedure of inducing a passive state in which the patient demonstrates increased amenability and responsiveness to suggestions and commands, provided they do not conflict seriously with the patient’s conscious or unconscious wishes.

Hypnotherapy may be used for either diagnostic or treatment purposes. This procedure is covered by most insurance plans.

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CPT Code 90882

 

Environmental Intervention for Medical Management Purposes on a Psychiatric Patient’s Behalf With Agencies, Employers, or Institutions

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The activities covered by this code include physician visits to a work site to improve work conditions for a particular patient, visits to community-based organizations on behalf of a chronically mentally ill patient to discuss a change in living conditions, or accompaniment of a patient with a phobia in order to help desensitize the patient to a stimulus.

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Other activities include coordination of services with agencies, employers, or institutions. This service is covered by some insurance plans, but because some of the activities are not face-to-face, the clinician should check with carriers about their willingness to reimburse for this code.

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CPT Code 90885

 

Psychiatric Evaluation of Hospital Records, Other Psychiatric Reports, Psychometric and/or Projective Tests, and Other Accumulated Data for Medical Diagnostic Purposes

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Although this would seem to be a very useful code, because reviewing data is not a face-to-face service with the patient, Medicare will not reimburse for this code and some commercial carriers have followed suit.

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Medicare considers the review of data to be part of the pre-/postwork associated with any face-to-face service.

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CPT Code 90887

 

Interpretation or Explanation of Results of Psychiatric, Other Medical Examinations and Procedures, or Other Accumulated Data to Family or Other Responsible Persons, or Advising Them How to Assist Patient

Medicare will not reimburse for this service because it is not done face-to-face with the patient, and clinicians should verify coverage by other insurers to ensure reimbursement. It is appropriate to use an E/M code in the hospital where floor time is expressed in coordination of care with the time documented.

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CPT Code 90889

 

Preparation of Report of Patient’s Psychiatric Status, History, Treatment, or Progress (Other Than for Legal or Consultative Purposes) for Other Physicians, Agencies, or Insurance Carriers

Psychiatrists are often called upon to prepare reports about the patient for many participants in the healthcare system. This code would be best used to denote this service. However, because this is not a service provided face-to-face with a patient, Medicare will not reimburse for this code either, and clinicians should verify coverage by other insurers.

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CPT Code 90899

 

Unlisted Psychiatric Service or Procedure

This code is used for services not specifically defined under another code. It might also be used for procedures that require some degree of explanation or justification.

If the code is used under these circumstances, a brief, jargon-free note explaining the use of the code to the insurance carrier might be helpful in obtaining reimbursement. If it is used for a service that is not provided face-to-face with a patient, the psychiatrist should check with the patient’s insurer regarding reimbursement.

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CPT Codes 95970, 95974, 95975

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Neurostimulators, Analysis–Programming

These codes have been approved for vagus nerve stimulation (VNS) therapy for treatment-resistant depression. Clinicians performing VNS therapy should use the appropriate code from the 95970, 95974, and 95975 series of codes found in the neurology subsection of the CPT manual. Medicare will not reimburse for these codes.

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M0064

 

Brief Office Visit for the Sole Purpose of Monitoring or Changing Drug

Prescriptions Used in the Treatment of Mental Psychoneurotic and Personality Disorders – M0064 is not, in fact, a CPT code. It is a HCPCS Level II code (CPT codes are HCPCS Level I), part of the HCPCS system used by Medicare and Medicaid. M0064 should only be used for the briefest medication check with stable patients

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Source: https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Practice-Management/Coding-Reimbursement-Medicare-Medicaid/Coding-Reimbursement/cpt-primer-for-psychiatrists.pdf

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Other Source:

 

https://www.aacap.org/App_Themes/AACAP/docs/clinical_practice_center/business_of_practice/cpt/2018_CPT_module_revised_March_2018.pdf

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