90836 CPT Code: Psychotherapy with medical evaluation, 30-60 minutes.

What is CPT Code 90836

CPT Code 90836 is often used specifically for reporting psychotherapy sessions that include a medical evaluation and management component. This code is typically used by mental health professionals when they use therapeutic interventions along with assessments that evaluate a patient’s mental health status. The distinct combination of psychotherapy and evaluation is crucial in providing thorough treatment plans catered to individual patient needs.

This code is part of a broader category of codes under the Current Procedural Terminology (CPT) that identify various types of therapeutic sessions. The significance of CPT code 90836 lies in its dual nature, allowing providers to bill for both the therapy conducted and any necessary medical evaluation that may be imperative for effectively treating mental health conditions.

Services Covered Under CPT Code 90836

Below is a table detailing the services covered under CPT Code 90836, highlighting their relevance and purpose in mental health treatment.

Who Can Use the 90836 CPT Code?

CPT Code 90836 can be utilized by several mental health professionals, ensuring comprehensive care delivery. The following are key providers accredited to use this code:

• Psychiatrists: Medical doctors specializing in the diagnosis and treatment of mental disorders.
• Clinical Psychologists: Licensed professionals providing psychological assessment and therapeutic services.
• Licensed Clinical Social Workers: Trained in psychotherapy and client support within a social work framework.

How to Use CPT Code 90836

The correct application of CPT Code 90836 is essential for proper billing and compliance. Here are recommended steps:

• Document the session duration accurately, ensuring it reflects the 45-60 minutes requirement.
• Verify that both psychotherapy and medical evaluation components were provided during the session.
• Use comprehensive notes detailing the therapy modalities applied and patient responses.
• Include specific diagnoses and treatment objectives to support proper code usage.

Reimbursement Rates for CPT Code 90836

Disclaimer: Reimbursement rates can vary significantly based on location, provider agreements, and time of service. This article is regularly updated to reflect average pricing.

Benefits of CPT Code 90836

Utilizing CPT Code 90836 offers several advantages that enhance the delivery of mental health services. The benefits are highlighted in the table below:

Common Mistakes to Avoid with CPT Code 90836

CPT Code 90836 is specific to combined psychotherapy and medical management services. Misuse of this code can result in audits and denials. Here's a look at common mistakes to avoid:

• Incorrect Documentation: Failing to provide sufficient details regarding the session can cause reimbursement issues. For example, a psychologist notes the session as only therapy without mentioning the medical evaluation, leading to possible denials.
• Misjudging Session Duration: Not meeting the required duration of 45 minutes can result in incorrect billing. For instance, if a social worker conducts a session lasting 30 minutes, this may not qualify under code 90836.
• Improper Use of Codes: Using 90836 when only psychotherapy is provided could be problematic. A psychiatrist who only engages in therapy without evaluating medication should use a different code.
• Inaccurate Code Linking: Linking this code to services not covered can lead to audits. For instance, if a medical clerk erroneously links 90836 to a group therapy session, this would lead to complications.

CPT Code 90836 vs Other Codes

A comparison of CPT Code 90836 with similar codes can provide insights into its appropriate use. Below is a comparative table:

Conclusion

CPT Code 90836 is a critical tool in mental health billing, allowing for the integration of psychotherapy and medical evaluation services within a single session. Accurate usage, documentation, and awareness of common pitfalls will facilitate better compliance and billing success in mental health practices.

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.