90833 CPT Code: Therapy add-on

What is 90833 CPT Code

The 90833 CPT code is designated as an add‑on for psychotherapy services that occur in conjunction with evaluation and management (E/M) services. This code allows healthcare providers to bill for psychotherapy when the session lasts at least 30 minutes. It primarily targets patients who may have mental health concerns that need to be addressed during their medical visits, facilitating an integrated approach to patient care.

By using the 90833 code, providers can ensure that they are compensated for the additional time spent in therapeutic intervention. This not only enhances the overall quality of care but also promotes a comprehensive treatment plan that addresses both physical and psychological health needs.

Services Covered Under 90833 CPT Code

This code encompasses various psychotherapy services provided during an E/M encounter. The following table details the services covered.

Who Can Use the 90833 CPT Code?

This code can be billed by a variety of licensed mental health professionals. The following professionals are typically eligible:

• Psychologists: Professionals conducting psychological assessments and therapy sessions.
• Psychiatrists: Medical doctors specializing in mental health who can prescribe medication and provide therapy.
• Clinical Social Workers: Licensed social workers offering therapeutic support and intervention.
• Licensed Professional Counselors: Counselors providing individual, group, or family therapy.

How to Use 90833 CPT Code

Billing for this code requires careful documentation and adherence to the following guidelines:

• Document Session Duration: Ensure the session lasts a minimum of 30 minutes. For example, if a patient receives 40 minutes of therapy, this can be billed alongside the E/M service.
• Record Session Details: Capture specific therapeutic interventions and patient responses. For instance, if cognitive behavioral therapy techniques were employed, note the patient’s engagement and progress.
• Link to E/M Service: Clearly connect the therapy session to the E/M service provided. If a patient’s health condition related to anxiety was addressed during a routine check-up, document this correlation.

Reimbursement Rates for 90833 CPT Code

Disclaimer: Reimbursement rates vary frequently and depend on numerous factors, including geographical location and individual insurance plans. This article will be updated to reflect average prices as changes occur.

Benefits of 90833 CPT Code

The use of this code brings various advantages to both providers and patients. The following table outlines these benefits.

Common Mistakes to Avoid with 90833 CPT Code

Mistakes in billing can lead to audits and denials, which can be detrimental to a practice’s financial health. To mitigate these risks, here are common mistakes to avoid:

• Incorrect Session Duration: Failing to meet the minimum 30-minute requirement can lead to denials. For instance, billing for a 25-minute session would not be reimbursed.
• Lack of Documentation: Not providing adequate details about the therapy session can lead to questions during audits. For example, omitting notes on therapeutic techniques used can result in a lack of justification for billing the code.
• Linking to Incorrect E/M Service: Failing to connect the therapy session to the relevant medical service may trigger denials. If a provider treats anxiety during a visit for hypertension but does not document the link, the claim may be rejected.
• Misuse by Non-Qualified Staff: Only licensed professionals can bill this code. If a case manager provides therapy without proper qualifications, it could lead to compliance issues.

90833 CPT Code vs other codes

Understanding how this code compares to similar CPT codes enhances effective billing practices. The following table provides a comparison.

Conclusion

The 90833 CPT code is essential for billing psychotherapy services that occur alongside evaluation and management services. It allows healthcare providers to address mental health needs within the context of broader medical care. Proper documentation, awareness of reimbursement rates, and understanding common mistakes are crucial for maximizing the benefits of this code. By effectively utilizing this code, practitioners can enhance patient care and ensure appropriate compensation for their services.

Disclaimer: This article is for informational purposes only and does not constitute legal or medical advice. Always consult professional guidelines and regulatory bodies for specific compliance requirements.