There are two changes in the psychiatry section of CPT for 2017 behavioral health billing. The first is the description of psychotherapy CPT codes were revised to remove the words “and/or family.” In 2016, CPT code 90832 was defined as “Psychotherapy, 30 minutes with patient and/or family member.” In 2017 the definition is “Psychotherapy, 30 minutes with patient.” Codes 90833, 90834, 90836, 90837, 90838, and 90839 were similarly revised.
Codes 90832, 90833, 90834, 90836, 90837, 90838 describe psychotherapy for the individual patient, although times are for face to face services with patient and may include informant(s). The patient must be present for all or a majority of the service.
Family psychotherapy now has time added to the description.
CPT code 90846 was revised from “Family psychotherapy (without the patient present),” to “Family psychotherapy (without the patient present), 50 minutes.”
CPT code 90847 was revised from “Family psychotherapy (conjoint therapy) (with the patient present),” to “Family psychotherapy (conjoint therapy) (with the patient present), 50 minutes.”
Psychotherapy codes follow the CPT time rule, which is that in order to bill the service; the clinician must meet the mid point of time. In this case, in order to bill either 90846 or 90847, the family therapy must be at least 26 minutes. As always, document time in the medical record when time is a descriptor.
CPT is making a clearer distinction between Individual and Family therapy.
Individual psychotherapy (codes 90832, 90834, 90837) may involve informants (i.e., family members, caregivers).
- A code’s stated time (e.g., 30 minutes) is relevant only for face-to-face time with the patient. No additional time is reported for time with the informant.
- Therapy using family psychotherapy techniques should be reported with either 90846 (without patient present) or 90847 (with patient present). 90846 and 90847 should not be reported for family therapy sessions shorter than 26 minutes.
- The patient must be present for all or a majority of the service.
- Do not report psychotherapy codes for sessions shorter than 16 minutes.
- Codes 90832, 90833, 90834, 90836, 90837, 90838 can be reported on the same-day as codes 90846 and 90847, provided that the services are separate and distinct. Be sure to include modifier 59 to emphasize that the services are separate and distinct.