Stacy Ramirez Consulting

Medical Billing and Consulting

Common Behavioral Health CPT Codes

Commonly used Mental Health CPT Codes

CPT CODEDURATIONNOTES
9079116-89 MinutesDiagnostic Evaluation including Mental Status Exam, History, and Recommendations. Most insurance plans allow this code to be used once per year per client.
9083216-37 MinutesIndividual Outpatient Psychotherapy services rendered for 30 minutes
9083438-52 MinutesIndividual Outpatient Psychotherapy services rendered for 45 minutes
9083753-89 MinutesIndividual Outpatient Psychotherapy services rendered for 60 minutes. 
9084626-74 MinutesFamily, or Couples, Therapy without the patient present
9084726-74 MinutesFamily, or Couples, Therapy with the patient present
9085345-60 MinutesGroup Therapy (including interpersonal interactions and support with several patients).  Oriented around 1 specific mental health problem (i.e. anxiety, depression, obesity, etc).  Cannot exceed 10 patients at 1 time.  Can only bill once per day.  Note based on my experience: Excluded from several BCBS Union plans.

Less Commonly Used Codes that Might Apply to your Practice

CPT CODEDURATIONNOTES
+90785in conjunction with time frame of regular CPT codeInteractive Complexity Add on Code. 
Can be used if at least one of the following communication difficulties is present:
1. The need to manage maladaptive communication among participants that complicates delivery of care.
2. Caregiver emotions/behavior that interfere with implementation of the treatment plan.
3. Evidence/disclosure of a sentinel event and mandated report to a third party with initiation of discussion of the sentinel event and/or report with patient and other visit participants.
4. Use of play equipment, physical devices, interpreter, or translator to overcome significant language barriers.

Cannot be used with Crisis code or E/M services when no psychotherapy service is also reported.  Note based on my experience: this is typically only used for in-person services but if there is an ASL/language translator present for telehealth insurance might cover it. Ask the specific insurance plan before billing.
90839*31-75 MinutesProcedure code for licensed mental health providers rendering crisis therapy (or psychotherapy for crisis). This code is used for sessions where the patient is exhibiting signs of high distress or under circumstances that demand immediate attention. This might include the obvious suicidal ideation but could also include symptoms of a panic attack or other other disabling anxiety or other overwhelming psychological symptoms that require immediate attention.  Certain documentation required.  Cannot be used when working with other clients while your client is experiencing a crisis.  Time does not need to be continuous.  Can be used instead of 90791 if a crisis occurs during the intake session (the next booked session would then be a 90791).
+9084016-31 Minutes ExtraAdd on service code for an additional 30 minutes of crisis therapy.  Can be used more than once per business day.  Time does not need to be continuous.  Must be used in conjunction with CPT code 90839.
*Notes tied to a Crisis CPT Code need to include the following documentation: start and end time of session, method of treatment, history of crisis state/mental status exam, an update to the treatment plan (including psychotherapy, mobilization of resources, and provision of psychotherapeutic intervention), and make note of referrals to another facility.  Crisis codes can be used if there is a combination of client and family member interactions but the client must receive the majority of care.  Crisis codes do not need to be used continuously.  If there are multiple times that the therapist meets with the client within the same business day, start and end times of all interactions must be noted in the progress note.