Psychotherapy Codes and Update to ICD-9 and CPT^® Code List

Starting January 1, 2013 all mental health providers must use new CPT^® code numbers for psychotherapy when billing insurance carriers, including Medicare. The fundamental services underlying these new codes will not change. This transition is a result of the Centers for Medicare and Medicaid Services (CMS) Five-Year Review of the psychotherapy codes conducted by the American Medical Association (AMA).

All mental health professionals including psychologists, psychiatrists, nurses and social workers delivering psychotherapy services will use the same applicable codes for psychotherapy, though psychiatry will change how they bill for medical services.  (90791, 90832-90840)

The single psychiatric diagnostic evaluation code will be replaced by two codes:

•  90791 – for a diagnostic evaluation
• 90792 – for diagnostic evaluation with medical services

CPT^® code 90792 is reserved for MD’s and prescribing providers only.

Modifier-AH is no longer required to bill the diagnostic evaluation to Medicare claims which describe that services were performed by a clinical psychologist, as these new codes are specifically for this provider type.

CPT^® code 96101 for testing will remain the same.

Here is the link to the updated CPT^® and ICD-9 Codes for Bariatric Surgery.

Tina Napora, CMA, CPC
ASMBS Insurance Committee

Bariatric Coding Email Hotline: Please send your questions or comments to Insurance@asmbs.org.