Insurance Claims, Codes You Need to Know

The 3 Most Often Used Mental Health CPT Codes

They are:

90791 – Intake session — to be billed for your first appointment with that patient exclusively

90834 – 45-55 Minute Individual Therapy Session

90837 – 56+ Minute Individual Therapy Session

Other Popular Codes Are

90904- EAP or Employee Assistance Program

90846 – Family or couples psychotherapy, without patient present.

90847 – Family or couples psychotherapy, with patient present.

90853 – Group Psychotherapy (not family)

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

It’s important to identify which type of service was provided in order to submit a claim properly and have proper documentation to support the type of session billed. 

Often times these CPT codes can become overwhelming when you have them all jumbled in your head so it’s best to have a guide for reference when doing your billing. 

Telehealth modifiers have also become more and more important to be aware of in the movement to online due to the pandemic, but will be useful to know for the future.

GT & 95 are the most popular and work with most commercial insurance.

POS or Place of Service is also a valuable piece of information to document. 

11- Office 

02- Telehealth 

If you want to bill for a telehealth session both the modifiers and the POS need to be indicated properly on the claim. 

Before COVID telehealth coverage was limited and the insurance companies have made an exception during this time. It will be interesting to see what will happen when the pandemic is over and whether policies around telehealth will be here to stay or not. 

If you’d like us to take care of this for you so you can ignore the hassle of cms-1500 forms just reach out and we’d be happy to help your practice.