Regarding medical billing, CPT codes are crucial in ensuring accurate and timely reimbursement. One such code is the 90837 CPT code, used to bill for individual outpatient psychotherapy services rendered for 60 minutes. However, many people often need clarification about the code’s specifics, including what it entails and when it should be used. This article will demystify the 90837 CPT code, providing a comprehensive guide to help you understand its intricacies.
Table of Contents
- What is the 90837 CPT code?
- When should the 90837 CPT code be used?
- What are the requirements for using the 90837 CPT code?
- CPT Code 90837 Fee Schedule 2023
- FAQs:
- Conclusion:
- Related Articles:
What is the 90837 CPT code?
The 90837 CPT code is a billing code used by mental health practitioners to bill for psychotherapy sessions that last longer than 50 minutes. Specifically, it is used to bill for sessions between 53 and 60 minutes. Here’s what you need to know about the code:
- The 90837 CPT code is time-based, meaning that the amount of time spent with the patient determines whether this code should be used.
- The code is often used for patients with severe mental health conditions that require longer therapy sessions.
- The 90837 CPT code can only be used once per patient daily, regardless of the number of therapy sessions provided.
When should the 90837 CPT code be used?
The 90837 CPT code should be used when the patient requires a more extended therapy session. This could be due to various factors, including the severity of their mental health condition or the complexity of their treatment plan. Here are some examples of situations where the 90837 CPT code may be appropriate:
- The patient has a severe mental health condition that requires longer therapy sessions to address adequately.
- The patient has a history of trauma, and longer therapy sessions are necessary to allow them to work through their past experiences.
- The patient is experiencing significant stressors that require additional therapy time to address.
What are the requirements for using the 90837 CPT code?
To use the 90837 CPT code, the therapist must meet the following criteria:
- The therapist must be a qualified mental health practitioner licensed to provide psychotherapy.
- The therapy session must last between 53 and 60 minutes.
- The therapy session must primarily focus on psychotherapy and not other services such as medication management.
CPT Code 90837 Fee Schedule 2023
| HCPCS Code | Short Description | Non-Facility Price | Facility Price | Non-Facility Limiting Charge | Facility Limiting Charge |
| 90837 | Psytx w pt 60 minutes | $147.07 | $129.45 | $160.67 | $141.42 |
Also Read: ICD Codes
FAQs:
Ans. Most insurance companies will reimburse for therapy sessions billed under the 90837 CPT code. However, checking with the specific insurance company to verify their coverage policies is always best.
Ans. The reimbursement amount for the 90837 CPT code varies depending on the insurance company and the therapist’s location. However, therapy sessions billed under the 90837 CPT code generally tend to have higher reimbursement rates than those billed under other codes.
Ans. Yes, the 90837 CPT code can be used with other codes, such as evaluation and management. However, ensuring that the codes used are appropriate for the services provided is essential.
Conclusion:
The 90837 CPT code is a necessary code used by mental health practitioners to bill for longer psychotherapy sessions. Understanding its intricacies is crucial for accurate and timely reimbursement. We hope this comprehensive guide has helped demyst. We hope this complete guide has helped demystify the 90837 CPT code and provided you with a better understanding of its requirements and uses. As always, consulting with insurance companies and complying with local and federal regulations when billing for mental health services is essential. Proper billing practices ensure reimbursement and help patients receive the care they need to manage their mental health conditions effectively.
In conclusion, the 90837 CPT code is crucial in billing for longer psychotherapy sessions. Its proper use requires understanding its specifics, such as when, what requirements to meet, and how to use it with other codes. Mental health practitioners and insurance companies must work together to ensure accurate and timely billing for mental health services to enable patients to receive the care they need to lead healthy and fulfilling lives.