247 Medical Billing Solutions is an essential source of hospital billing services, providing professional guidance and assistance to medical professionals. The standard for psychotherapy therapies, Psychotherapy CPT Code 90839, is used for psychological care billing. However, how does this code effectively work? Let’s explore the details of code 90839 to provide the information you need to handle the billing conditions properly.
Definition
A particular kind of psychotherapist session is indicated by the CPT code 90839 for psychotherapy. To help people handle their state of mind, cognitive-behavioral approaches are used in a 60-minute session. Insurance companies pay healthcare providers using this code when they charge for these services.
90839 Time Requirement
There is a time limitation related to procedure code 90839. If the session does not last over 60 minutes, you may bill a routine procedure code (90834 or 90832, depending on how much time was spent).
To be sure you can bill using this code, be careful to keep track of the time spent.
Code Description
The following components are highlighted in CPT code 90839 original description:
- Only individual sessions with a psychotherapist are eligible for this code.
- Only individuals who have already formed a therapy relationship with the therapist are qualified to use this code.
Two of three therapy elements, a minimum of two of the components that follow need to be discussed in the session:
- Diagnosis and assessment: This process includes determining the patient’s mental health condition and developing a diagnosis.
- Planning a treatment: creating a treatment strategy based on the objectives and unique requirements of the patient.
- Intervention implementation: Administering therapeutic interventions, such as psychodynamic or cognitive-behavioral therapy,
Evaluation and Management
CPT code 90839 falls under evaluation and management (E/M) services. The clinical opinion that comes into a patient’s treatment is a part of E/M services. This refers to the psychotherapist’s evaluation of the individual’s psychological condition, developing a treatment strategy, and using therapeutic procedures.
Documenting medical necessity
When charging emergency codes, check that your paperwork refers to the information that follows and makes it easily readable and accessible:
- An initial evaluation of medical strength, mental health, and risk
- The requirement for additional assessment or referrals (if appropriate) for other mental health services
- Communication with people who might have relevant information for the evaluation
- Substance use (if any)
- Result of the meeting
- Suicidal ideation is one of the main presentations that require crisis management, while there are also many other possibilities as well. The SAFE-T is an excellent resource, but there are many options.
Billing
When paying for a psychotherapy session, applying the CPT code 90839 appropriately and including all required paperwork is essential. This contains a thorough session note covering the patient’s development and the particular cognitive-behavioral approaches employed.
Keep the following information in mind when charging for the CPT code 90839 on the reimbursement form:
- The name and birthdate of the patient
- The service date
- The CPT number is 90839.
- The number of units invoiced (one unit for every 60-minute session)
- The codes for diagnosis
Crisis Therapy Billing Recommendations
We know that several therapists need to record their crisis treatment sessions accurately. Make an appointment with your behavioral health reimbursement department for guidance if you need it.
CPT code 90839: Recommended Billing:
- Add more than one diagnosis and use the proper one.
- Make use of specific diagnoses (rather than Dx).
- After two hours of work, charge 90839 + 90840.
- If your services are rendered outside of regular business hours, apply add-on CPT code 99050.
- Include CPT add-on code 99051 if they occur during regularly planned holidays, weekends, or evening hours.
- Because crisis meetings are unscheduled, you must make an authorized phone call within a day of the session.
90839 Requirements & Documentation
The circumstance requires immediate treatment of a very anxious patient. This implies that it is crucial to record the situation’s medical needs. Document the risk, any recommendations for additional services, and correspondence with other parties.
Does 90839 Require Authorization?
Typically, previous approval is optional for CPT code 90839. Because of the sensitive nature of an emergency psychotherapy session, calling the insurance company to find out if they would cover this code is frequently just not feasible. Tragically, not all insurance providers will pay for this; Medicare, particularly, has a reputation for not delivering crisis codes. Additionally, there can be restrictions on how many times it can be billed in a certain period.
Calling the insurance provider to determine whether to bill 90839 or 90837 for routine treatment is still a good idea.
Reimbursement Rates
Psychotherapy CPT code 90839 reimbursement rates differ based on the individual’s contract or the insurance provider. Healthcare professionals must check the accurate payment rate for this code by contacting all insurance companies.
2024 Reimbursement Rate of CPT Code 90839: $144.07
For a 60-minute private psychotherapy meeting, CPT code 90839 usually pays slightly higher than CPT code 90837. As 90839 allows, 90840 pays at a rate for almost half the time.
Treatment for Crisis.
Medicare released the 2020 CPT Code 90839 Reimbursement Rates, which are as follows:
Medicare will reimburse $157.66 for a 60-to-90-minute session of crisis treatment under CPT Code 90839.
Conclusion
In summary, the CPT code 90839 for psychotherapy indicates a certain kind of psychotherapy session. Cognitive-behavioral strategies are used in a 60-minute session to help patients manage their mental health. Medical professionals charge for these treatments utilizing this code, which insurance companies reimburse. It is crucial to use this code appropriately and supply all required documentation when paying for it. Using this code appropriately and providing all the necessary documentation when paying for it is essential. Medical professionals must confirm the precise reimbursement rate for this code by contacting each insurance company, as reimbursement rates differ based on the patient’s plan and the insurer.