90832 CPT Code, 90834 CPT Code, and 90837 CPT Code describe individual psychotherapy services for the patient and may include an informant. The patient is required to be present for all or most of the service. The codes include an ongoing assessment and adjustment of treatment interventions. The times for these codes are:
- 90832: Psychotherapy 30 minutes. Time range: 16 to 37 minutes
- 90834: Psychotherapy 45 minutes. Time range: 38 to 52 minutes
- 90837: Psychotherapy 60 minutes. Time range: 53 minutes or more
All mental health professionals including psychologists, psychiatrists, nurses and social workers delivering psychotherapy services use the same applicable CPT® codes when billing clients and filing health insurance claims with third-party payers, including Medicare, Medicaid and private health insurance carriers.
With all three of the individual psychotherapy codes; 90832, 90834, and 90837, the intention of the AMA is to capture only the face-to-face time spent on clinical discussion and therapy, not any administrative discussions, including scheduling questions, collecting fees, or time spent before or after the session for capturing documentation. While therapists may block off a straight hour for the session on their calendars, only the time spent on therapy can be billed for reimbursement.
90834 CPT code should be used when you spend between 38 and 52 minutes in therapy; not for any session over 30 minutes. Some health insurance companies may consider 90834 as the standard psychotherapy session. In such cases when reporting 90837, it would be beneficial to document in the clinical record why the longer service was warranted rather than the shorter service.
Add-on Codes for 90834
There are “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.
Add-on Code 90785: 90785 is an add-on code used to report interactive complexity services. It is reported in conjunction with 90791, 90832, 90834, 90837, and 90853.
Add-on code 90863: 90863 is used for pharmacologic management, including prescription and review of medication, when performed on the same day as one of the stand-alone psychotherapy codes (90832, 90834, 90837). A psychologist providing a psychotherapy service with medication management should report the 90863 add-on code along with the applicable psychotherapy code.
90834 CPT Code vs 90837 CPT Code
Both 90834 and 90837 are designed to bill for the same service – Psychotherapy. The primary distinguishing factor between the two codes is time; 90834 is defined as 45 minutes of psychotherapy, while 90837 is defined as 60 minutes. Both codes are intended to capture only the face-to-face time spent on therapy, not any of the administrative components of the session such as collecting copays, scheduling future appointments, or writing notes.
As defined by the CPT, 90834 should be used when you spend an estimated 38–52 minutes on therapy with the client, and 90837 is for all therapy sessions that are at least 53 minutes long. This means a traditional 50-minute therapy hour should be billed as 90834; however, this also means that you should be rightfully reimbursed for longer sessions with 90837.
For accurate Mental/Behavioral Health medical billing, knowing your CPT codes is the most important thing. In our blog series of ‘Know Your Codes’ or ‘KYC,’ we have discussed the most common CPT codes in detail and when to use them. E2E Medical Billing Services is known for it’s accurate Mental/Behavioral Health medical billing and coding. To know more about our services call us at 888-552-1290 or write to us at info@e2eMedicalBilling.com