How To Use CPT Code 90901

CPT 90901 refers to biofeedback training by any modality, a procedure that helps patients control involuntary bodily functions. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 90901.

1. What is CPT 90901?

CPT 90901 is a medical billing code used for biofeedback training by any modality. This procedure involves training patients to control involuntary bodily functions, such as blood pressure, heart rate, and muscle tension, by altering brain activity. Biofeedback training is used to treat various conditions, including asthma, addiction, high blood pressure, chronic pain, depression, headache, incontinence, and more.

2. 90901 CPT code description

The official description of CPT code 90901 is: “Biofeedback training by any modality.”

3. Procedure

The 90901 procedure involves the following steps:

1. The provider assesses the patient’s condition and determines if biofeedback training is an appropriate treatment.
2. The provider selects the appropriate biofeedback modality based on the patient’s condition and needs.
3. The patient is connected to biofeedback equipment that measures and responds to changes in bodily functions, such as temperature, heart rate, blood pressure, and muscle tension.
4. The provider guides the patient through practices to alter their bodily functions, using feedback from the equipment in the form of lights, sounds, and meters.
5. The patient learns to control their reactions to the feedback, ultimately gaining control over their involuntary bodily functions.
6. The provider monitors the patient’s progress and adjusts the treatment plan as needed.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 90901 services include those who:

• Have a medical condition that can be treated or managed through biofeedback training, such as asthma, addiction, high blood pressure, chronic pain, depression, headache, incontinence, and more.
• Are able to understand and follow the provider’s instructions during the biofeedback training sessions.
• Have not responded well to other treatments or therapies for their condition.
• Are willing to commit to the time and effort required for biofeedback training, which may involve multiple sessions over several weeks or months.

5. When to use CPT code 90901

It is appropriate to bill the 90901 CPT code when a provider performs biofeedback training by any modality for a patient who meets the qualifying circumstances listed above. The provider must determine that biofeedback training is a suitable treatment option for the patient’s condition and that the patient is capable of participating in the training sessions.

6. Documentation requirements

To support a claim for CPT 90901, the following information should be documented:

• A detailed description of the patient’s medical condition and the rationale for using biofeedback training as a treatment option.
• A comprehensive treatment plan, including the specific biofeedback modality used, the frequency and duration of sessions, and the expected outcomes.
• Progress notes for each biofeedback training session, including the patient’s response to the treatment and any adjustments made to the treatment plan.
• Documentation of the patient’s progress toward achieving the desired outcomes, including any improvements in their condition or symptoms.

7. Billing guidelines

When billing for CPT code 90901, it is essential to follow the appropriate guidelines and rules. Some tips and codes that apply to CPT code 90901 include:

• Ensure that the patient meets the qualifying circumstances for biofeedback training and that the treatment is medically necessary.
• Document the treatment plan, progress notes, and outcomes thoroughly to support the claim.
• Bill for each biofeedback training session separately, using the 90901 CPT code for each session.
• Check with the patient’s insurance provider for any specific billing requirements or limitations related to biofeedback training.

8. Historical information

CPT 90901 was added to the Current Procedural Terminology system on January 1, 1997. There have been no updates to the code since its addition.

9. Similar codes to CPT 90901

Five similar codes to CPT 90901 and how they differ are:

• CPT 90911: This code is used for biofeedback training specifically for the treatment of incontinence, rather than any modality.
• CPT 90875: This code refers to individual psychophysiological therapy incorporating biofeedback training, which combines psychotherapy with biofeedback.
• CPT 90876: This code is for group psychophysiological therapy incorporating biofeedback training, involving multiple patients in a group setting.
• CPT 96150: This code is for health and behavior assessment, which may include biofeedback as part of a broader assessment of a patient’s health behaviors.
• CPT 96151: This code is for health and behavior intervention, which may involve biofeedback training as part of a larger intervention plan to address health behaviors.

10. Examples

Here are 10 detailed examples of CPT code 90901 procedures:

1. A patient with chronic migraines undergoes biofeedback training to learn how to control muscle tension in their neck and shoulders, reducing the frequency and severity of their headaches.
2. A patient with high blood pressure participates in biofeedback training to learn how to lower their blood pressure through relaxation techniques and breathing exercises.
3. A patient with anxiety and panic attacks undergoes biofeedback training to learn how to control their heart rate and breathing, reducing the intensity of their symptoms.
4. A patient with chronic pain from fibromyalgia participates in biofeedback training to learn how to manage their pain through relaxation techniques and muscle control.
5. A patient with irritable bowel syndrome undergoes biofeedback training to learn how to control their abdominal muscles and reduce the severity of their symptoms.
6. A patient with insomnia participates in biofeedback training to learn how to control their brain waves and improve their sleep quality.
7. A patient with attention deficit hyperactivity disorder (ADHD) undergoes biofeedback training to learn how to increase their focus and attention through brain wave control.
8. A patient with post-traumatic stress disorder (PTSD) participates in biofeedback training to learn how to control their physiological responses to triggers and reduce the intensity of their symptoms.
9. A patient with Raynaud’s disease undergoes biofeedback training to learn how to control their blood flow and reduce the severity of their symptoms.
10. A patient with addiction participates in biofeedback training to learn how to control their cravings and physiological responses to triggers, supporting their recovery process.