CPT Codes For Mental Health
Table of Contents
This list provides detailed descriptions and practical examples of various Current Procedural Terminology (CPT) codes used in mental health services. These codes are essential for mental health professionals, such as psychologists, therapists, and counselors, as they categorize and standardize the wide range of services provided. Each code specifies a particular type of service, its duration, and context, ensuring accurate documentation and appropriate reimbursement for services rendered. Whether it’s psychotherapy sessions, diagnostic evaluations, or behavioral interventions, this comprehensive guide helps clarify the usage of each CPT code to facilitate better understanding and application in clinical practice.
Who Uses These Mental Health CPT Codes?
CPT codes are primarily used by a range of healthcare professionals and entities involved in providing and managing mental health services. These include:
- Mental Health Professionals: Psychologists, psychiatrists, therapists, counselors, and social workers use CPT codes to document and bill for the services they provide to patients.
- Medical Coders and Billers: These professionals use CPT codes to translate healthcare services into standardized codes for billing purposes, ensuring that insurance companies can process claims accurately.
- Insurance Companies: Health insurers use CPT codes to determine reimbursement rates for various mental health services and to process claims submitted by healthcare providers.
- Healthcare Administrators: Administrators in clinics, hospitals, and private practices use CPT codes for scheduling, billing, and managing healthcare services.
- Regulatory Agencies: Organizations like the Centers for Medicare & Medicaid Services (CMS) use CPT codes to regulate and standardize the billing process across the healthcare industry.
- Researchers and Analysts: These professionals use CPT codes to collect data on healthcare utilization, costs, and trends in mental health services for research and policy-making purposes.
- Patients: While not directly using CPT codes, patients benefit from the standardization they provide, ensuring clarity and consistency in their billing statements and insurance claims.
Understanding and correctly applying CPT codes is crucial for the efficient operation of mental health services, accurate billing, and appropriate reimbursement.
Common CPT Codes in Mental Health Services: Descriptions and Examples
90791
Description: Psychiatric diagnostic evaluation without medical services. Example: A psychologist conducts an initial evaluation of a new patient to diagnose a mental health disorder, spending 60 minutes on the assessment.
90832
Description: Psychotherapy, 30 minutes with patient. Example: A therapist meets with a patient for a brief therapy session to address anxiety management techniques.
90834
Description: Psychotherapy, 45 minutes with patient. Example: A counselor holds a 45-minute session with a patient to work through cognitive-behavioral therapy techniques for depression.
90837
Description: Psychotherapy, 60 minutes with patient. Example: A psychotherapist conducts a one-hour session with a patient focusing on trauma recovery strategies.
90839
Description: Psychotherapy for crisis, first 60 minutes. Example: A therapist provides immediate, intensive support to a patient experiencing a severe panic attack for the first 60 minutes.
90840
Description: Psychotherapy for crisis, each additional 30 minutes. Example: Following an initial crisis session, the therapist continues to work with the patient for an additional 30 minutes to stabilize their condition.
90846
Description: Family psychotherapy (without the patient present), 50 minutes. Example: A psychologist conducts a session with the parents of a child with behavioral issues to discuss strategies for home management.
90847
Description: Family psychotherapy (with the patient present), 50 minutes. Example: A therapist holds a session with a teenager and their parents to address communication and relationship issues within the family.
90849
Description: Multiple-family group psychotherapy. Example: Several families attend a group therapy session to discuss shared experiences and support each other in dealing with a common issue, such as substance abuse.
90853
Description: Group psychotherapy (other than of a multiple-family group). Example: A therapist leads a weekly support group for individuals coping with social anxiety.
90875
Description: Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the patient), with psychotherapy, 30 minutes. Example: A therapist uses biofeedback to help a patient manage stress responses during a 30-minute session.
90876
Description: Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the patient), with psychotherapy, 45 minutes. Example: A clinician combines biofeedback with cognitive-behavioral therapy in a 45-minute session to help a patient with chronic pain.
90880
Description: Hypnotherapy. Example: A therapist uses hypnotherapy techniques to help a patient quit smoking during a 60-minute session.
90882
Description: Environmental intervention for medical management purposes on a psychiatric patient’s behalf with agencies, employers, or institutions. Example: A psychologist communicates with a patient’s employer to develop a suitable work environment plan to support their mental health needs.
90901
Description: Biofeedback training by any modality. Example: A therapist uses biofeedback to teach a patient how to control physiological functions, such as heart rate, to reduce anxiety.
96105
Description: Assessment of aphasia (includes assessment of expressive and receptive speech and language function, language comprehension, speech production ability, reading, spelling, and writing). Example: A neuropsychologist conducts an assessment to diagnose and measure the severity of aphasia in a patient post-stroke.
96112
Description: Developmental test administration (includes assessment of motor, language, social, adaptive, and/or cognitive functioning by standardized developmental instruments), first hour. Example: A psychologist administers a developmental test to a young child to assess cognitive and motor skills during a one-hour session.
96113
Description: Developmental test administration, each additional 30 minutes. Example: After the initial hour, the psychologist continues the developmental assessment for another 30 minutes to complete the evaluation.
96116
Description: Neurobehavioral status exam (clinical assessment of thinking, reasoning, and judgment, including a detailed history and examination and scoring and interpretation of standardized tests), first hour. Example: A neuropsychologist conducts a one-hour assessment to evaluate a patient’s cognitive functions and behavior following a head injury.
96121
Description: Neurobehavioral status exam, each additional hour. Example: The neuropsychologist extends the evaluation by an additional hour to gather comprehensive data on the patient’s condition.
96130
Description: Psychological testing evaluation services by physician or qualified healthcare professional, first hour. Example: A psychologist administers and interprets a series of psychological tests to diagnose a mental health disorder during an initial one-hour session.
96131
Description: Psychological testing evaluation services by physician or qualified healthcare professional, each additional hour. Example: The psychologist spends an additional hour evaluating test results and refining the diagnosis.
96132
Description: Neuropsychological testing evaluation services by physician or qualified healthcare professional, first hour. Example: A neuropsychologist conducts the first hour of neuropsychological testing to assess cognitive deficits in a patient with suspected dementia.
96133
Description: Neuropsychological testing evaluation services by physician or qualified healthcare professional, each additional hour. Example: The neuropsychologist spends additional hours analyzing test data to provide a detailed cognitive assessment.
96136
Description: Psychological or neuropsychological test administration and scoring by physician or qualified healthcare professional, first 30 minutes. Example: A psychologist administers and scores the first 30 minutes of a cognitive assessment test.
96137
Description: Psychological or neuropsychological test administration and scoring by physician or qualified healthcare professional, each additional 30 minutes. Example: The psychologist continues the test administration and scoring for another 30 minutes to complete the assessment.
96138
Description: Psychological or neuropsychological test administration and scoring by technician, first 30 minutes. Example: A trained technician administers and scores a psychological test during the initial 30-minute session.
96139
Description: Psychological or neuropsychological test administration and scoring by technician, each additional 30 minutes. Example: The technician spends an additional 30 minutes completing the administration and scoring of the test.
96156
Description: Health behavior assessment or re-assessment (e.g., health-focused clinical interview, behavioral observations, clinical decision making). Example: A health psychologist conducts an assessment to evaluate a patient’s health behaviors and develop a behavior modification plan.
96158
Description: Health behavior intervention, individual, face-to-face, initial 30 minutes. Example: A psychologist works with a patient for 30 minutes on techniques to improve diet and exercise habits.
96159
Description: Health behavior intervention, individual, face-to-face, each additional 15 minutes. Example: The psychologist continues the intervention for an additional 15 minutes to reinforce the health behavior strategies.
96164
Description: Health behavior intervention, group (2 or more patients), face-to-face, initial 30 minutes. Example: A health psychologist leads a 30-minute group session focused on stress management techniques.
96165
Description: Health behavior intervention, group (2 or more patients), face-to-face, each additional 15 minutes. Example: The group session is extended by another 15 minutes to cover additional stress management strategies.
96167
Description: Health behavior intervention, family (with the patient present), face-to-face, initial 30 minutes. Example: A psychologist works with a patient and their family for 30 minutes to develop a healthier lifestyle plan.
96168
Description: Health behavior intervention, family (with the patient present), face-to-face, each additional 15 minutes. Example: The session with the patient and their family is extended by 15 minutes to address additional health behavior concerns.
96170
Description: Health behavior intervention, family (without the patient present), face-to-face, initial 30 minutes. Example: A psychologist meets with the family of a patient for 30 minutes to discuss ways to support the patient’s health goals.
96171
Description: Health behavior intervention, family (without the patient present), face-to-face, each additional 15 minutes. Example: The family session is extended by 15 minutes to further explore strategies for supporting the patient’s health behavior changes.
Understanding and correctly applying CPT codes is crucial for the efficient operation of mental health services. These codes not only facilitate accurate billing and reimbursement but also help ensure standardized documentation across the healthcare industry. By familiarizing yourself with these CPT codes and their specific applications, you can enhance the clarity and precision of your practice, leading to better patient outcomes and streamlined administrative processes. Whether you’re a mental health professional, medical coder, or healthcare administrator, this comprehensive guide serves as an essential resource for navigating the complexities of mental health service coding. Embrace the power of these standardized codes to improve your practice and ensure that patients receive the appropriate care and support they need.