How To Use CPT Code 90833

CPT 90833 is an add-on code for psychotherapy services performed in conjunction with an evaluation and management service, typically lasting between 16 to 37 minutes. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 90833 procedures.

1. What is CPT 90833?

CPT 90833 is an add-on code used to report psychotherapy services provided in conjunction with an evaluation and management (E/M) service. This code is specifically used when the psychotherapy session lasts between 16 to 37 minutes. The purpose of this code is to accurately document and bill for the additional time and effort spent by the provider in delivering psychotherapy services alongside the primary E/M service.

2. 90833 CPT code description

The official description of CPT code 90833 is: “Psychotherapy, 30 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure)”.

3. Procedure

1. Provider performs an evaluation and management service for the patient.
2. Provider conducts a psychotherapy session with the patient, lasting between 16 to 37 minutes.
3. Provider documents the duration and content of the psychotherapy session, as well as the E/M service provided.
4. Provider bills CPT 90833 in addition to the primary E/M code to accurately report the services rendered.

4. Qualifying circumstances

Patients eligible to receive CPT 90833 services are those who require psychotherapy in addition to an evaluation and management service. These patients typically present with mental or emotional health problems that warrant therapeutic intervention. The provider must determine that the patient’s condition necessitates both an E/M service and a psychotherapy session lasting between 16 to 37 minutes.

5. When to use CPT code 90833

It is appropriate to bill CPT 90833 when the following conditions are met:

• The provider performs an evaluation and management service for the patient.
• The provider conducts a psychotherapy session with the patient that lasts between 16 to 37 minutes.
• The psychotherapy session is a necessary component of the patient’s treatment plan.
• The provider documents the duration and content of the psychotherapy session, as well as the E/M service provided.

6. Documentation requirements

To support a claim for CPT 90833, the provider must document the following information:

• The primary evaluation and management service performed, including the appropriate E/M code.
• The duration of the psychotherapy session, which must fall within the 16 to 37-minute range.
• A description of the psychotherapy techniques used and the patient’s response to treatment.
• A clear indication that the psychotherapy session was a necessary component of the patient’s treatment plan.

7. Billing guidelines

When billing for CPT 90833, providers should adhere to the following guidelines:

• Report CPT 90833 as an add-on code, in addition to the primary E/M code.
• Ensure that the psychotherapy session duration falls within the 16 to 37-minute range.
• Document the E/M service and psychotherapy session thoroughly, as outlined in the documentation requirements section.
• Do not report CPT 90833 without an appropriate primary E/M code, as payers will not reimburse for the add-on code alone.

8. Historical information

CPT 90833 was added to the Current Procedural Terminology system on January 1, 2013. The code was changed on January 1, 2017, with the previous descriptor being “Psychotherapy, 30 minutes with patient and/or family member when performed with an evaluation and management service (List separately in addition to the code for primary procedure)”.

9. Similar codes to CPT 90833

Five similar codes to CPT 90833 and how they differentiate are:

1. CPT 90832: Used for psychotherapy sessions lasting 16 to 37 minutes without an additional E/M service in the same session.
2. CPT 90834: Used for psychotherapy sessions lasting 38 to 52 minutes without an additional E/M service in the same session.
3. CPT 90836: An add-on code for psychotherapy sessions lasting 38 to 52 minutes when performed with an E/M service.
4. CPT 90837: Used for psychotherapy sessions lasting 53 minutes or longer without an additional E/M service in the same session.
5. CPT 90838: An add-on code for psychotherapy sessions lasting 53 minutes or longer when performed with an E/M service.

10. Examples

1. A patient with depression receives a medication management E/M service and a 25-minute psychotherapy session.
2. A patient with anxiety undergoes a physical examination and a 30-minute psychotherapy session to address their symptoms.
3. A patient with post-traumatic stress disorder receives a psychiatric evaluation and a 20-minute psychotherapy session.
4. A patient with bipolar disorder has a medication adjustment E/M service and a 35-minute psychotherapy session.
5. A patient with an eating disorder receives a nutritional assessment and a 16-minute psychotherapy session.
6. A patient with obsessive-compulsive disorder undergoes a psychiatric evaluation and a 28-minute psychotherapy session.
7. A patient with a substance use disorder receives a medication management E/M service and a 22-minute psychotherapy session.
8. A patient with a personality disorder undergoes a psychiatric evaluation and a 32-minute psychotherapy session.
9. A patient with a phobia receives a behavioral assessment and a 26-minute psychotherapy session.
10. A patient with a sleep disorder undergoes a sleep study evaluation and a 30-minute psychotherapy session to address related anxiety.