You may be familiar with CPT codes used for Occupational Therapist assessment if you work in healthcare, but are you aware of CPT Code 90847?
This code is essential for mental health therapists and can be used for families or couples’ treatment with the patient involved.
Treatment called family or couple counseling involves more than one patient—instead of just one. Mental health therapists can charge insurance companies for treatment sessions that include individuals and their companions or family members by using 90847 CPT code. Specialists who work with patients who struggle with familial issues or relationships might benefit from this code.
Definition
Billing for families or couples sessions with therapists is done with CPT code 90847. This code is applied if a psychotherapist treats many patients simultaneously with psychotherapy. Either in-person or remote treatment sessions are available.
CPT Code 90847 Description
In CPT Code 90847, the patient stays present throughout the family or couple’s treatment.
These meetings must last for a minimum of 26 minutes. This is the CPT code for two clients seeking continuous couples therapy or marital and family therapy. You cannot bill both clients; this is accepted as a single “service code” and will often result in a more significant reimbursement.
Evaluation and Management
To use 90847 CPT code effectively, one must thoroughly understand evaluation and management techniques. Therapists must comprehensively analyze the interactions inside the family or couple when using this code. The investigation of communication difficulties, mental health concerns on both levels of individuals and groups, and any other relevant problems affecting interpersonal interactions within a group should all be included in this evaluation.
The following has to be recorded in the medical record of the patient by the psychotherapist when applying CPT code 90847:
- The theory behind the treatment meeting
- How long the session lasted
- Patients who were in attendance during the session
- The counseling session’s purpose
- Improvements that are achieved in the treatment
How is CPT Code 90847 Used in Psychotherapy Billing?
- A psychotherapist uses it when treating couples and family members in the absence of patients.
- Either in-person or internet treatment sessions are available.
- Healthcare professionals such as psychiatrists, psychologists, nursing staff, or counselors apply this code for billing for couple or family therapy sessions.
- The 90847 CPT code is usable in treatment sessions with two or more closely linked persons.
- The length of the treatment session, the time and place, the people who attended, and the topics covered must all be included in the documentation of the treatment session.
How do I code couples therapy correctly?
The billing for your first session will be the same as for every other first session in which a patient is present. It is permissible to apply the 90847 CPT code for marital/family therapy while the patient is current for continuing couples treatment and the 90846 CPT code when the patient is absent.
What happens if you need to schedule a private session with one individual? This is another occasion when things get complicated, so you should figure out the patient immediately. You would use a person’s treatment code if you had access to the patient for a session without the presence of other family members, such as the partner or spouse.
More thoroughly, the National Association of Professional Social Workers states that family-based psychotherapy services can be determined by the CPT 90846, even in situations where the patient is not present. This specific code is applied when a patient receives different and unique individual psychotherapy services on the same day. The session lasts 50 minutes and lasts 26 mins or longer.
The 90847 CPT code represents family psychological treatment with the patient, often called conjoint psychotherapy. If the patient receives individual psychological treatment and the 90847 code on the same day, the two treatments can be used separately. The therapy session lasts 50 minutes and takes at least 26 minutes.
Reimbursement Rates
To manage their finances appropriately, healthcare professionals need to be familiar with the payment rates associated with CPT code 90847. A few aspects that could affect the reimbursement rate are the region, payment regulations, and specific agreements between the insurance company and the healthcare provider.
It is recommended that physicians keep themselves updated on the current reimbursement rates in their geographic region and, where practical, work out profitable contracts with payers. It is ensured that professionals are fairly compensated for the essential psychological counseling they give by routinely reviewing and adjusting price schedules.
90847 Reimbursement Rates for Family & Couples Therapy
It is necessary for medical professionals who provide family and couples therapy sessions to be up to date on reimbursement rates. Medicare provides the national payment threshold for family counseling with the individual in presence under 90847 CPT code.
The following are the CPT Code 90847 reimbursement rates:
- 2024 Reimbursement Rate: $100.53
- 2023 Reimbursement Rate: $99.63
- 2022 Reimbursement Rate: $111.15
- 2021 Reimbursement Rate: $102.59
Billing Tip
When paying for CPT code 90847, it is essential to apply the correct modifier. When emphasizing that the treatment session differed from another service offered on the same day, the modifier “59” needed to be used. This will lessen the possibility that the insurance provider will reject the claim.
Conclusion
Knowing the 90847 CPT code is vital for any medical professional providing family therapy services. Medical professionals who provide family therapy services make billing and reimbursement procedures more precise and efficient by using CPT codes, ensuring compliance with industry standards. Though they have different uses in the billing process, it is essential to understand the distinction between CPT and HCPCS codes.
CPT code 90847 will enable you to bill for family counseling services and appropriately receive reimbursement. You may confidently handle the billing system if you know its meaning, timing limitations, and documentation needs. Don’t forget that adding the correct modifiers and keeping up with current reimbursement rates will improve your claim even more.