Psychotherapy CPT (Current Procedural Terminology) codes are essential for mental health professionals who bill insurance companies for therapy services. These codes classify different types of psychotherapy sessions, including individual, group, and family therapy, making it easier for providers to get reimbursed for their services.
Understanding the correct CPT codes for psychotherapy helps avoid claim denials, ensures accurate reimbursement, and keeps billing compliant with insurance guidelines. This article provides an in-depth guide to psychotherapy CPT codes, their usage, and billing best practices.
What Are Psychotherapy CPT Codes?
CPT codes are five-digit numeric codes used by healthcare providers to report medical, diagnostic, and therapeutic services to insurance companies. The American Medical Association (AMA) maintains and updates these codes annually.
For mental health professionals, psychotherapy CPT codes cover different session lengths, types of therapy, and patient settings.
Commonly Used Psychotherapy CPT Codes
1. Individual Psychotherapy CPT Codes
These codes are used for one-on-one therapy sessions with clients:
- 90832 – 16-37 minutes of individual psychotherapy.
- 90834 – 38-52 minutes of individual psychotherapy (most common).
- 90837 – 53+ minutes of individual psychotherapy (extended session).
When to use:
- These codes apply to face-to-face sessions (in-person or telehealth).
- 90834 is the standard for 45-minute sessions, while 90837 is used for longer sessions.
2. Family and Couples Therapy CPT Codes
For therapy sessions involving family members or couples, use:
- 90846 – Family therapy without the patient present.
- 90847 – Family therapy with the patient present.
When to use:
- Use 90846 when discussing family dynamics without the client in the room.
- Use 90847 when the client is actively participating in the session.
3. Group Psychotherapy CPT Code
For therapy sessions involving multiple participants in a group setting:
- 90853 – Group psychotherapy (not family).
When to use:
- Used for structured group therapy sessions (e.g., support groups for anxiety, addiction, or PTSD).
4. Psychological and Neuropsychological Testing Codes
For psychological assessments and testing, use:
- 96130 – Psychological testing by a qualified professional (first hour).
- 96131 – Each additional hour of psychological testing.
- 96132 – Neuropsychological testing by a qualified professional (first hour).
- 96133 – Each additional hour of neuropsychological testing.
When to use:
- These codes apply when conducting in-depth psychological assessments for diagnostic purposes.
Psychotherapy CPT Codes for Telehealth Services
With the rise of online therapy, telehealth CPT codes are essential for remote mental health services.
- 90832, 90834, 90837 – Standard individual therapy codes are also used for telehealth.
- 90846, 90847 – Family therapy can also be conducted via telehealth.
- Modifier -95 – Used to indicate the session was conducted via telehealth.
Billing Tip:
- Ensure your telehealth platform is HIPAA-compliant and check with insurance companies about telehealth coverage.
Psychotherapy Add-On CPT Codes
These codes are billed in addition to primary CPT codes when extra services are provided.
- +90785 – Interactive complexity (e.g., nonverbal clients, interpreters needed).
- +99354 – Extended psychotherapy session (extra 30-60 minutes).
- +99355 – Each additional 30 minutes beyond 99354.
When to use:
- 90785 is used when sessions involve high emotional intensity or require third-party assistance.
- 99354 & 99355 are used for prolonged therapy sessions lasting more than 90 minutes.
Best Practices for Billing Psychotherapy CPT Codes
- Choose the Correct CPT Code Based on Session Length
- Avoid upcoding (billing for a longer session than provided).
- Avoid undercoding (billing for a shorter session, which reduces reimbursement).
- Use Modifiers When Necessary
- Modifier -95 for telehealth sessions.
- Modifier -25 if psychotherapy is provided on the same day as a medical evaluation.
- Check Insurance Reimbursement Policies
- Some insurance companies require pre-authorization for CPT 90837 (53+ minutes).
- Medicare and Medicaid may have different billing guidelines.
- Document Thoroughly
- Maintain detailed session notes to support billing claims.
- Include session start and end times in records.
- Stay Updated with CPT Code Changes
- CPT codes are updated yearly by the AMA.
- Insurance companies may have different reimbursement rates for each CPT code.
Final Thoughts: Mastering Psychotherapy CPT Code Billing
Understanding psychotherapy CPT codes is crucial for accurate billing and timely reimbursement. By selecting the correct CPT codes, applying necessary modifiers, and following insurance guidelines, therapists can streamline their billing process and avoid claim denials.
For those new to private practice or billing, consulting with a medical billing specialist or using billing software (such as SimplePractice or TherapyNotes) can help simplify the process.