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Navigating the labyrinth of mental health billing can be a daunting task, particularly when it comes to understanding Current Procedural Terminology (CPT) codes. One such code that often surfaces in this context is CPT code 90834. This code is primarily used to bill for individual psychotherapy sessions.
In this blog, we will demystify the key aspects and implications of CPT code 90834, including its comparison with other codes like CPT code 90837.
We’ll also delve into their specific applications for 45-minute and 60-minute psychotherapy sessions. Read on to streamline your billing procedures and ensure effective reimbursement.
On the other hand, CPT Code 90837 is designated for longer psychotherapy sessions, typically lasting around 60 minutes. Therapists use this code when providing extended therapy services to their patients. Just like CPT Code 90834, the reimbursement rate for CPT Code 90837 may vary depending on the payer, location, like in New York the reimbursement rate for CPT code 90837 is $144.83.
It’s essential for mental health practitioners to be aware of the reimbursement rates for these codes to ensure accurate billing and appropriate reimbursement for the services provided.
Additionally, staying up-to-date with any changes in reimbursement policies and guidelines can help avoid claim denials and ensure smooth financial operations within a mental health practice.
For sessions billed under CPT Code 90834, therapists should select the diagnosis code that best represents the patient’s mental health condition being addressed during the 45-minute therapy session.
The diagnosis code should be chosen from the appropriate code set, such as the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). Selecting the precise diagnosis code ensures alignment between the therapy session’s purpose and the patient’s documented condition.
Similarly, when using CPT Code 90837 for extended 60-minute therapy sessions, mental health practitioners must select an accurate diagnosis code that justifies the need for longer therapy services. This diagnosis code should reflect the patient’s specific mental health condition that requires intensive therapy over the extended session duration.
By correctly associating the relevant diagnosis codes with CPT Code 90834 and CPT Code 90837, mental health professionals ensure appropriate billing and enhance the chances of successful reimbursement.
Accurate diagnosis coding provides valuable information to insurance payers about the necessity and appropriateness of the therapy services rendered, supporting the overall transparency and integrity of the billing process.
Understanding and correctly utilizing CPT codes 90834 and 90837 are essential for mental health practitioners to navigate the complexities of billing for psychotherapy sessions. CPT code 90834 is used for standard 45-minute individual therapy sessions, while CPT code 90837 is employed for extended 60-minute sessions. Ensuring accurate session duration and appropriate code selection are crucial to avoid billing errors and maximize reimbursement.
Adding Modifier 95 indicates that psychotherapy sessions were conducted via telehealth, enabling proper reimbursement eligibility for remote sessions.
Being aware of the reimbursement rates for these codes, as well as the specific diagnosis codes, is vital to ensure proper billing and successful reimbursement. Practitioners should stay informed about any changes in reimbursement policies and guidelines to maintain smooth financial operations within their mental health practice.