When it comes to running a successful business as a mental health practitioner, there’s a hefty load of responsibility. This is especially true for the mental health billing process.
While there are many technical requirements to consider, one of the most important factors is knowing the basics of Current Procedural Terminology (CPT) codes to help maximize your reimbursements.
What Are CPT Codes?
Current Procedural Terminology codes are used when billing a client’s insurance company in order to describe the treatment and assessment offered to the patient. The codes allow the mental health practitioner to be reimbursed for the care that they provided.
The challenge, when it comes to CPT codes, is that there are hundreds of different codes you can use to describe the services rendered. For example, CPT codes can describe length of the therapy session, or an intake interview.
How Do CPT Codes Work?
CPT codes tell insurance companies what you would like to be paid for. By using the correct code, the insurance companies can reimburse you for the session, treatment, and other services you provided.
CPT codes work alongside ICD codes, or International Classification of Diseases codes. The IDC code describes why the treatment was necessary, or the health concern, and the CPT code describes the care that was provided for that concern.
In the mental health industry, an example of a set of codes could be F60.3 and 90832. The F60.3 is the ICD code, and is the corresponding code for borderline personality disorder. The second code, 90832, is the CPT code, which indicates 30 minutes of individual psychotherapy.
Tips to Remember When Choosing Your CPT Code
There are some basic categories for CPT codes that you will be using in your mental health billing. Here are some tips for when you’re choosing your code.
Three Categories
There are three categories of CPT codes. Most of the codes you will use will be in Category 1, where the majority of the codes reside.
Category 2 codes are optional codes that simply provide extra information about the diagnosis and treatment.
Category 3 codes are temporary codes that describe experimental treatments or technology. If there is not a code for the service you provided in Category 1, then you might use a code from Category 3.
Common Mental Health CPT Codes
Here are a few more examples of CPT codes that can be found in the mental health services field:
- 90832: 30 minutes of individual psychotherapy
- 90834: 45 minutes of individual psychotherapy
- 90837: 60 minutes of individual psychotherapy
- 90847: 50 minutes of family psychotherapy with the patient present
- 90846: 50 minutes of family psychotherapy without the patient present
- 90791: Psychiatric or psychological intake review without medical services
Many health care professionals have transitioned either partially or completely to online counseling, and telehealth CPT codes change slightly. For example, a 90832 code with a 95 modifier still describes 30 minutes of psychotherapy. The modifier simply indicates interaction between counselor and patient via a telecommunication system such as video conferencing.
Why are CPT Codes Important?
Ultimately, if you want to get reimbursed fairly, then knowing how to correctly use CPT codes is paramount.
CPT codes allow you to be reimbursed from insurance companies for the services you provide for your clients. Using the correct code could make a big difference in the amount of reimbursement you receive.
A correct CPT code also allows you to avoid audits from insurance companies. Billing for the wrong treatment would mean that you were paid for the wrong service.
Remember, it would be inappropriate to bill for the wrong level of service that you provided for your client. Always ensure that what you are billing for only covers the level of treatment that the client has received.
Get Mental Health Billing Support
Are you spending too much time on insurance rather than focusing on your clients? We can help!
Anchor Point Billing Solutions helps you increase revenue, shorten collection time, and eliminate the administrative burden of in-house billing operations.
If you have any questions regarding CPT codes or the billing of your services, reach out to us today to schedule a consultation and simplify your billing process!