To keep your organization successful and provide your patients with the best care possible, it is crucial in psychological treatment to have accurate and efficient billing procedures. Therapists must have a strong understanding of Current Procedural Terminology (CPT) codes to deal with all aspects of insurance payment effectively.
The details of Psychotherapy CPT Code 90836, frequently used to provide psychotherapy treatments to established patients, will be covered in this blog article. You can improve your financial situation and billing procedures by learning these details.
Definition
When linked with a behavioural assessment and management service, use the extension code for private psychological counselling that lasts 45 minutes and is insight-oriented, behaviour-modifying, supportive, or occurs along the individual being treated and a family member (time range: 45–50 minutes). It includes in-person conversations on diagnosing, handling, and maintaining emotional, mental, and behavioural health issues.
Time Length
The time-limited characteristic of CPT Code 90836 represents one of its key components. It is equivalent to 45 to 50 minutes for individual psychological counselling. 90836 is a valuable number for billing since it is specifically created for this affordable duration, while various codes might involve shorter or longer sessions.
Code Description
The correct description for CPT code 90836, supplied by the American Medical Association (AMA), outlines the essential components of a psychological counselling session.:
Individual psychotherapy
Only one patient receives the services throughout the therapy session.
45 minutes
A minimum of 45 minutes must pass throughout the session. A patient is considered stable if they have visited the psychotherapist for a minimum of two previous sessions of psychotherapy in the last three months.
Treatment and management
The primary goals of the session are to identify the mental health issue that the patient has, put treatment plans into action, and track the individual’s progression.
Evaluation and Management
Psychotherapy services are the focus of CPT code 90836. However, it’s essential to distinguish it from other evaluation and management (E/M) codes. Psychotherapist codes focus on treating and managing recognized disorders, whereas E/M codes include examining and diagnosing a patient’s condition.
A comprehensive assessment of the individual’s psychological status and constant treatment management is essential to effective psychotherapy. Psychotherapy (CPT Code 90836) includes evaluation, administration, and coordination of treatment besides the direct interaction used directly with the individual receiving treatment and the therapist. Because of this integrative approach, every part of the patient’s psychological condition is considered and effectively treated during the session.
How is CPT code 90836 used in psychotherapy billing?
In the billing system, for various purposes, use CPT code 90836.
- A 45-minute psychotherapy treatment can be added on using CPT code 90836.
- Professionals can use it in behaviour-modifying, interpersonal psychological treatment and support.
- It pairs with other psychotherapist codes, such as E/M or crisis therapy codes.
- CPT codes represent Psychotherapy 90832–908338.
- Psychotherapy without medical assessment and management services is indicated by 90832, 90834, and 90837.
Billing
It is essential to record the time spent in the meeting and the exact tasks accomplished when billing under Code 90836. Efficient and precise documentation confirms that all services meet the code’s standards. To prevent any billing problems, therapists should also be informed of the policies and procedures that insurance companies have established regarding using this code.
Billing Tip
Psychologists should carefully document the time and duration of each session in their clients’ notes to ensure precise and timely payment for CPT code 90836, besides providing compliance with billing regulations. The main points of the psychotherapy session should be included in the documents, such as:
- The timing and date of the meeting
- The illness’s signs and concerns at this time
- The interventions that were carried out at the meeting
- How the patient reacted to the treatments
- The overall progress of the meeting
- Upcoming treatment plans
Reimbursement Rates
Depending on the insurance company, code 90836 (used for a 45-minute session of personalized counselling with assessment and management services) has different payment rates. The following are the code 90836 reimbursement rates derived from the given search results:
Medicare Reimbursement Rate
$98.30 is the reimbursement from the Medicare rate for mental health professionals using CPT code 90836.
Medicaid Reimbursement Rate
The supplied search results do not include the Medicaid reimbursement rate for code 90836.
There are several factors which impact the reimbursement rate for code 90836. These considerations include:
- Where the psychologist lives
- Policy
- The patient’s insurer
- The healthcare company’s in-network status for the therapist
What is the difference between CPT code 90836 and 90837?
Psychotherapy billing is handled using codes 90836 and 90837; however, each code’s time requirements differ. A 45-minute psychotherapy session can be added to CPT code 90836, and a 60-minute psychotherapy session can be added to CPT code 90837. According to this breakdown, sessions lasting more than 52 minutes should use CPT number 90837, while sessions lasting between 45 and 50 minutes should use CPT code 90836.
It’s essential to remember that these codes may only be used in conjunction with a distinct psychotherapy code; they are not valid for more than the first session when combined with add-on codes like 90840. In addition, CPT codes denote psychotherapy 90832–908338, among which 90832, 90834, and 90837 specifically denote the lack of medical assessment and management services in psychotherapy.
Conclusion
In conclusion, psychotherapy CPT Code 90836 represents individual treatment sessions lasting 45 to 50 minutes. It is essential to the area of psychological health billing. Mental health therapists must become familiar with all aspects of this code to record and invoice their services precisely. The code’s evaluation and management sections highlight how comprehensive psychotherapy is and how crucial it is to care for a patient’s mental health in every aspect.