The American Medical Association (AMA) announced several changes to the Current Procedural Terminology (CPT) codes used by mental and behavioral health providers in 2023. Some of these changes aim to better reflect current mental health treatment approaches and models of care, while others serve to clarify requirements and components of the codes. Download the guide here.
99492 – Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional
99493 – Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities
96202 – Multifamily group training session, first 60 minutes
96203 – Multifamily group training session, each addition 15 minutes
+96131 – Add-on code to 96130, Psychological testing, interpretation, and reporting by a psychologist (per additional 60 minutes)
+90833 – Add-on code to 90832. 30 minutes of psychotherapy when performed with an evaluation and management service (List separately in addition to the code for primary procedure)
+90836 – Add-on code to 90834. 45 minutes of psychotherapy when performed with an evaluation and management service (List separately in addition to the code for primary procedure)
+90838 – Add-on code to 90837. 60 minutes of psychotherapy when performed with an evaluation and management service (List separately in addition to the code for primary procedure)
+90785 – Interactive complexity add-on
+90840 – Each additional 30 minutes of psychotherapy for crisis
+90863 – Pharmacologic Management post therapy
Codes for psychotherapy services have been updated and revised to outline the requirements and elements of individual psychotherapy sessions more clearly. The codes that have been revised are as follows:
Instead of codes 96158 and 96151, providers should now use 96156 to bill for health and behavior assessment/reassessment. It is now event-based rather than the previous time-based.
Instead of code 96152, providers are now to use 96158 and 96159 to bill for an individual, face-to-face health behavior intervention for 30 minutes, and additional 15-minute increments.
Instead of code 96153, providers are now to use 96164 and 96165 to bill for face-to-face group health interventions in 30-minute and 15-minute increments.
Instead of code 96154, providers are now to use codes 96167 and 96168 to bill for face-to-face family health behavior intervention (patient is present) in 30-minute and 15-minute increments.
Instead of code 96155, providers are to use codes 96170 and 96171 to bill for face-to-face family health behavior intervention (patient is not present) in 30-minute and 15-minute increments.
Two family psychotherapy codes have been deleted and replaced with add-on codes to individual psychotherapy codes:
90846 – Family psychotherapy (without the patient present)
90847 – Family psychotherapy (conjoint psychotherapy) (with patient present)
Codes 99354, 99355, 99356, and 99357 were deleted as well. These codes were for prolonged service provided by therapists for sessions longer than an hour for specialized treatment, including ketamine-assisted psychotherapy in inpatient or outpatient, observation, or nursing facilities.
Replaced with G2212 for Medicare (15-minute intervals) or 99417 for commercial pay.
These updates to CPT codes for mental and behavioral health providers reflect a growing effort to respond to the evolving needs of patients and healthcare providers in the field of mental health. The new codes reflect the shift to an integrated approach to mental health treatment, including the inclusion of primary care in the treatment of mental illnesses. Providers should review the new and revised codes to determine how they might impact billing and reimbursement in 2023.
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