Once again, with feeling: coding for behavioral health Coding for Behavioral Health Compliance lessons from the OIG Post-discharge Telephonic Follow-up Contacts Intervention | G0544 Digital Mental Health Treatment | G0552, G0553, G0554 Safety Planning Interventions | G0560 It’s been a year (seems like a minute) since the OIG released a report on coding for behavioral […]
Medicare Coverage for Marriage and Family Therapists and Mental Health Counselors
In the Consolidated Appropriations Act, 2023 Congress mandated that Medicare provide coverage and payment for the services of health professionals who are Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs). The effective date of coverage is January 1, 2024. And of course, these professionals must enroll in Medicare in order to provide the […]
Coding for Behavioral Health Services by Psychologists, Social Workers and Therapists
Looking for a coding resource for behavioral health therapists? It’s here. Therapists use CPT codes to describe what services they perform and ICD-10 codes to establish the medical necessity for the service. This 30 minute overview describes the coding rules for the psychiatric diagnostic evaluation, psychotherapy, psychotherapy for patients in crisis and interactive complexity.
Psychiatric Diagnostic Evaluation
There are two codes for psychiatric diagnostic evaluation. 90791 Psychiatric diagnostic evaluation 90792 Psychiatric diagnostic evaluation with medical services 90791 is used by psychologists, social workers and other licensed behavioral health professional and 90792 is used by psychiatrists and psychiatric nurse practitioners and physician assistants, because it includes medical services. Here is how CPT® defines […]
Psychotherapy Codes
Individual psychotherapy codes are time based codes. One set may be reported as a stand alone service, and another during the same visit as medication management. They follow the CPT time rule: use the code when the mid-point in the defined time is met. The CPT book itself lists the time thresholds at the start […]
Psychotherapy for Patients in Crisis
Page down for 2024 HCPCS codes for G0017, G0018 90839 is the code for psychotherapy for crisis; first 60 minutes. 90840 is an add-on code for each additional 30 minutes of time spent with a patient who is in crisis. These codes do not have CPT® limitations on place of service. They would typically be […]
Interactive Complexity | CPT® 90785
Code 90785 is an add-on code for interactive complexity and may be added on to the diagnostic psychiatric evaluation (90791, 90792), to psychotherapy services (90833—90838), and to group psychotherapy (90853). It may not be reported with an E/M service, if no psychotherapy is performed on that day, or with psychotherapy for crisis, 90839, 90840. Code […]