Clinical social work is an essential practice defined by the National Association of Social Workers as a “specialty practice area of social work which focuses on the assessment, diagnosis, treatment, and prevention of mental illness, emotional, and other behavioral disturbances.” 

Clinical Social Workers (CSWs) provide incredible service to their clients in a variety of settings, just as private practice, hospitals, mental health facilities, and more.

As CSWs provide care, they are able to bill for their services to an individual’s insurance company or organization to be reimbursed financially for those services. In doing so, these professionals are required to file claims for reimbursement that involve the correct application of clinical social work CPT codes. Social work CPT codes are applied to a claim so that an insurance claim can identify the services that were rendered to their beneficiary. 

Errors in social work CPT codes lead to denied claims that delay reimbursement and hurt a provider’s bottom line. Below, providers can find a list of the top clinical social work and Psychotherapy CPT codes as well as how to improve their billing process. 

Top Clinical Social Work CPT Codes:

90791 – This code is designated for psychiatric diagnostic evaluation involving the collection of history, mental status, and professional recommendation. This code is designated for evaluations ONLY and is not to be applied to the delivery of therapeutic services. 

90832,90834,90837 – These three social work CPT codes are designated for the delivery of individual psychotherapy services. The differentiations reflect the time of the visit, and code 90832 reflects 16-37 minutes, code 90834 is 38-52 minutes, and code 90837 is 53 minutes or more. 

90785 – This code is an add-on CPT code that reflects interactive complexity in a visit. It should only be used in tandem with the previous four codes along with code 90853, never on its own. 

90839-90840 – These social work CPT codes reflect crisis psychotherapy or the delivery of urgent assessments involving the client’s mental state, an examination of their mental status, and their disposition. These are meant to be used in matter or urgency only, with code ending in 39 used for the first 60 minutes and code ending in 40 for each additional 30 minutes.

90845 – This is designated for psychoanalysis services. 

90846 – If a provider renders psychotherapy services to the family without the patient present, this code should be used. 50 minutes. 

90847 – Family psychotherapy session WITH patient present. 50 minutes. 

90853 – Group therapy sessions. 

How to Improve Clean Claims:

Making sure you bill accurately does not have to be a pain. Too many clinical social workers waste hours and hours of their time on billing only to receive denials for their hard-earned reimbursements due to errors in their coding. It is not the job of a mental health expert to also be a billing expert. Electronic billing alongside billing services removes the hassle of insurance billing to focus on the care you are delivering to your clients. 

Providers should delegate the hassle of billing across a quality digital platform designed to maximize mental health reimbursements. Quality billing software comes with helpful features such as: 

Claim Scrubbing

This is the process of your digital solution “scrubbing” each claim clean of errors in social work ICD codes prior to it being submitted. This increases the number of clean claims you submit and streamlines your reimbursement. 

EHR Integration

Your entire system should be integrated to make your job easier. One system for billing, scheduling, records, notes, treatment plans, prescribing, and more enables a provider to work faster and minimize mistakes along the way. 

Managed billing services allow a provider to hand over their complicated billing processes to true billing experts who will help them grow their bottom line. Benefits of utilizing managed billing services include:

Access to Experts

Where you are the expert in clinical social work services, let billing experts handle your claims. They are experts in payer requirements, social work billing codes, and all other billing details that optimize your revenue. 

Dedicated Specialist

Gain peace of mind that your billing is being handled by a trusted person by accessing a dedicated billing specialist who takes your account personally. They are available to answer questions and keep you up to date on all things billing.