How to Use CPT Codes for Billing and Reimbursement in Your Practice

As a psychologist or psychotherapist, it's important to understand how to use CPT codes for billing and reimbursement in your practice. CPT codes, or Current Procedural Terminology codes, are a standardized set of codes used by healthcare providers to communicate with insurance companies and other payers for billing purposes. In this blog post, we'll discuss how to use CPT codes effectively in your practice to ensure you get paid for your services.

Understand the Different CPT Codes

There are many different CPT codes available for psychologists and psychotherapists. It's important to understand the different codes and what they mean so that you can accurately bill for your services. Some of the most common codes used by psychologists and psychotherapists include:

90834: Individual psychotherapy, 45 minutes

90837: Individual psychotherapy, 60 minutes

90847: Family psychotherapy (with patient present), 50 minutes

90846: Family psychotherapy (without patient present), 50 minutes

90832: Individual psychotherapy, 30 minutes

It's important to note that the time listed in the code refers to face-to-face time with the patient. Time spent on documentation or other administrative tasks is not billable.

Code Appropriately

It's important to code appropriately for the services you provide. This means selecting the correct code for the type and duration of therapy provided. Using the wrong code can result in claims being denied or delayed. Make sure to document the start and end time of each session, as well as the type of therapy provided, to ensure accurate coding.

Keep Up with Changes to CPT Codes

CPT codes are updated annually, and it's important to keep up with these changes to ensure accurate billing. Make sure to review the updates each year and make any necessary changes to your billing practices. You can find the latest CPT code updates on the American Medical Association website.

Use Modifiers When Necessary

Modifiers are two-digit codes used to provide additional information about a service provided. For example, modifier 59 is used to indicate a service that is distinct or independent from other services provided on the same day. Make sure to use modifiers appropriately to avoid claim denials or delays.

Submit Claims Promptly

It's important to submit claims promptly to ensure timely reimbursement for your services. Most insurance companies have specific timelines for submitting claims, so make sure to check with each payer to ensure compliance. Make sure to include all necessary information on the claim, including the patient's insurance information and the CPT codes for the services provided.

In conclusion, using CPT codes effectively is essential for psychologists and psychotherapists to ensure accurate billing and reimbursement for their services. Make sure to understand the different codes, code appropriately, keep up with changes to CPT codes, use modifiers when necessary, and submit claims promptly. By following these tips, you can ensure that your practice is properly reimbursed for the valuable services you provide to your patients.

‍