The new psychotherapy codes: What psychologists need to know,
part 2

This article addresses basic changes, add-on codes, pharmacological management and crisis codes

Sept. 27, 2012—In the Sept. 13 issue of PracticeUpdate, we began introducing you to the new psychotherapy codes for 2013. This article provides additional information that practitioners need to know about the codes.

Basic changes

Importantly, the changes in store for 2013 involve only the psychotherapy family of codes – the codes found in the Psychiatry section of the 2013 CPT® manual. There are no changes to other codes that psychologists use, such as testing or health and behavior codes.

As of Jan. 1, most psychiatric diagnostic and therapeutic services will have new code numbers, while most of the codes now used for these services will be eliminated. Be on the lookout for a code number reference list that the APA Practice Organization plans to send to members in early October.

The three new psychotherapy codes for use in all settings are:

  • 90832, Psychotherapy, 30 minutes with patient and/or family member

  • 90834, Psychotherapy, 45 minutes with patient and/or family member

  • 90837, Psychotherapy, 60 minutes with patient and/or family member

Add-on codes

There will be new “add-on” codes for specific services that can be provided only in combination with other diagnostic evaluation, psychotherapy and group psychotherapy services. Add-on codes identify an additional part of the treatment above and beyond the principal service. Both the principal service code and add-on code should be listed on the billing form.

The codes for interactive psychotherapy are being eliminated and replaced with an add-on code to capture “interactive complexity.”

Interactive complexity, new add-on code 90785, refers to factors that complicate the delivery of a psychiatric procedure. Complicating factors include difficult communication with acrimonious family members and engagement of verbally undeveloped children. These factors are typically found with patients who:

  • Have others legally responsible for their care, such as minors or adults with guardians

  • Request others such as family members or interpreters to be involved during the visit, or

  • Require the involvement of third parties such as schools or probation officers

Code 90785 may be reported with codes for diagnostic evaluation, psychotherapy and group psychotherapy. At least one of several circumstances identified in the CPT manual that complicate the delivery of care must pertain in order for providers to bill the interactive complexity code as an add-on to the principal psychiatric procedure.

Pharmacologic management

Of particular interest to prescribing psychologists, a new add-on Code 90863 will be used for pharmacologic management, including prescription and review of medication, when performed with psychotherapy services. A psychologist providing a psychotherapy service with medication management should report the 90863 add-on code along with the applicable new psychotherapy code identified above. 

Prescribing health care professionals who provide evaluation and management (E/M) services as well as psychotherapy will also have the following options, depending on the type of service delivered. They will report an E/M code along with a psychotherapy add-on code if both E/M and psychotherapy are provided, or they will simply report an E/M code if only E/M is provided.

New crisis codes

There is a new principal code for a crisis psychotherapy session requiring urgent assessment and history of the crisis state, mental status exam and disposition. A new add-on code applies to crisis psychotherapy sessions lasting longer than 60 minutes.

In order for the new crisis codes to apply, the presenting problem must typically be life threatening or complex and require immediate attention to a patient in high distress.

Code 90839 will be billed for the first 60 minutes of psychotherapy for a patient in crisis, and add-on code 90840 will be billed for each additional 30 minutes of psychotherapy for crisis. For more information related to billing the crisis codes, consult the 2013 CPT® manual. Copies of the manual can now be ordered from the American Medical Association online or by calling toll-free, (800) 621-8335.

The APA Practice Organization will continue to provide members with extensive information and resources over the next three months to help you prepare for using the new codes on Jan. 1. Visit regularly to learn what you need to know.

Current procedural terminology (CPT®) copyright 2011 American Medical Association. All Rights Reserved.