How To Use CPT Code 90875

CPT 90875 is a code used for individual psychophysiological therapy incorporating biofeedback training with psychotherapy for 30 minutes. This article will cover the description, procedure, qualifying circumstances, when to use, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 90875.

1. What is CPT 90875?

CPT 90875 is a medical billing code used to describe a specific type of therapy session that combines psychophysiological therapy with biofeedback training and psychotherapy. This code is used when the therapy session lasts for 30 minutes. The purpose of this therapy is to help patients learn to control their physiological processes and improve their mental and emotional health through a combination of biofeedback and psychotherapy techniques.

2. 90875 CPT code description

The official description of CPT code 90875 is: “Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the patient), with psychotherapy (eg, insight oriented, behavior modifying or supportive psychotherapy); 30 minutes.”

3. Procedure

The 90875 procedure involves the following steps:

1. The provider assesses the patient’s mental and emotional health, as well as their physiological processes.
2. Using biofeedback equipment, the provider monitors the patient’s physiological processes, such as heart rate and blood pressure.
3. The provider teaches the patient relaxation techniques and other methods to help them control their physiological processes.
4. The provider engages the patient in psychotherapy, using techniques such as insight-oriented, behavior modifying, or supportive psychotherapy.
5. The therapy session lasts for 30 minutes, during which the provider and patient work together to improve the patient’s mental and emotional health.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 90875 services are those who have been diagnosed with a psychiatric illness or mental health disorder that can benefit from psychophysiological therapy and biofeedback training. This may include patients with anxiety disorders, depression, post-traumatic stress disorder (PTSD), or other conditions that affect their mental and emotional well-being. The provider must determine that the patient is an appropriate candidate for this type of therapy and that the therapy is medically necessary for the patient’s condition.

5. When to use CPT code 90875

It is appropriate to bill the 90875 CPT code when the provider performs a 30-minute therapy session that combines psychophysiological therapy with biofeedback training and psychotherapy. The provider must ensure that the patient meets the qualifying circumstances for this type of therapy and that the therapy is medically necessary for the patient’s condition. Additionally, the provider must document the therapy session and the patient’s progress in their medical records to support the claim for CPT 90875.

6. Documentation requirements

To support a claim for CPT 90875, the provider must document the following information in the patient’s medical records:

• The patient’s diagnosis and the medical necessity for psychophysiological therapy with biofeedback training and psychotherapy.
• A detailed description of the therapy session, including the specific biofeedback techniques used and the type of psychotherapy provided.
• The duration of the therapy session, which must be 30 minutes.
• The patient’s progress and response to the therapy, including any changes in their physiological processes or mental and emotional health.
• Any follow-up appointments or additional therapy sessions that may be necessary for the patient’s treatment plan.

7. Billing guidelines

When billing for CPT code 90875, providers should follow these guidelines:

• Ensure that the patient meets the qualifying circumstances for this type of therapy and that the therapy is medically necessary for their condition.
• Document the therapy session and the patient’s progress in their medical records to support the claim for CPT 90875.
• Bill for the 30-minute therapy session using CPT code 90875.
• If the therapy session lasts for 45 minutes, use CPT code 90876 instead.

8. Historical information

CPT 90875 was added to the Current Procedural Terminology system on January 1, 1997. The code was changed on January 1, 2013, with the previous descriptor being “Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the patient), with psychotherapy (eg, insight oriented, behavior modifying or supportive psychotherapy); approximately 20-30 minutes.”

9. Similar codes to CPT 90875

Five similar codes to CPT 90875 and how they differentiate are:

1. CPT 90876: This code is used for a 45-minute therapy session that combines psychophysiological therapy with biofeedback training and psychotherapy.
2. CPT 90832: This code is used for a 30-minute individual psychotherapy session without the incorporation of biofeedback training.
3. CPT 90834: This code is used for a 45-minute individual psychotherapy session without the incorporation of biofeedback training.
4. CPT 90901: This code is used for biofeedback training by any modality, without the incorporation of psychotherapy.
5. CPT 90911: This code is used for biofeedback training specifically for the treatment of urinary incontinence, without the incorporation of psychotherapy.

10. Examples

Here are 10 detailed examples of CPT code 90875 procedures:

1. A patient with an anxiety disorder receives a 30-minute therapy session that combines psychophysiological therapy with biofeedback training and insight-oriented psychotherapy.
2. A patient with depression receives a 30-minute therapy session that combines psychophysiological therapy with biofeedback training and supportive psychotherapy.
3. A patient with PTSD receives a 30-minute therapy session that combines psychophysiological therapy with biofeedback training and behavior modifying psychotherapy.
4. A patient with a stress-related disorder receives a 30-minute therapy session that combines psychophysiological therapy with biofeedback training and relaxation techniques.
5. A patient with a panic disorder receives a 30-minute therapy session that combines psychophysiological therapy with biofeedback training and cognitive-behavioral therapy.
6. A patient with a phobia receives a 30-minute therapy session that combines psychophysiological therapy with biofeedback training and exposure therapy.
7. A patient with obsessive-compulsive disorder receives a 30-minute therapy session that combines psychophysiological therapy with biofeedback training and habit reversal training.
8. A patient with a somatic symptom disorder receives a 30-minute therapy session that combines psychophysiological therapy with biofeedback training and mindfulness-based psychotherapy.
9. A patient with a dissociative disorder receives a 30-minute therapy session that combines psychophysiological therapy with biofeedback training and psychodynamic psychotherapy.
10. A patient with an eating disorder receives a 30-minute therapy session that combines psychophysiological therapy with biofeedback training and dialectical behavior therapy.