A psychiatric diagnostic interview examination is the elicitation of a complete medical and psychiatric history (including past, family and social), completion of a comprehensive mental status exam, establishment of a tentative diagnosis, and an evaluation of the patient’s ability and willingness to work to solve the patient’s mental problem.
An interactive medical psychiatric diagnostic interview is an initial evaluation typically furnished to children. This interview involves the use of physical aids and non-verbal communication to overcome barriers to therapeutic action between the clinician and the patient who has not yet developed, or has lost, either the expressive language communication skills to understand the clinician if he/she were to use ordinary adult language for communication.
List With CPT Codes For Psychiatric Services
The following CPT codes can be used for phychiatric services. CPT 90801, CPT 90802, CPT 90804 – CPT 90809, CPT 90804 – CPT 90809, CPT 90810 – CPT 90815, CPT 90846, CPT 90847, CPT 90849, CPT 90853 & CPT 90857. Underneath the description of the CPT codes for Phychiatric Services.
Description of CPT 90801: Psychiatric diagnostic interview examination.
Description of CPT 90802: Interactive psychiatric diagnostic interview examination using play equipment, physical devices, language interpreter, or other mechanisms of communication.
CPT 90804 – CPT 90809
Description of CPT 90804 – CPT 90809: Insight oriented, behavior modifying and or supportive psychotherapy.
CPT CPT 90810 – CPT 90815:
Description of CPT 90810 – CPT 90815: Interactive Psychotherapy.
Description of CPT 90846: Family Psychotherapy (without the patient present).
Description of CPT 90847: Family Psychotherapy (with the patient present).
Description of CPT 90849: Multiple-family group psychotherapy.
Description of CPT 90853: Group psychotherapy (other than of a multiple-family group).
Description of CPT 90857: Interactive group psychotherapy.
Place of Service Codes for Psychiatric Services
- POS 03: School
- POS 04: Homeless Shelter
- POS 11: Office
- POS 12: Patient’s Home
- POS 14: Group Home
- POS 20: Urgent Care
- POS 22: Outpatient Hospital
- POS 23: Emergency Room – Hospital
- POS 49: Independent Clinic
- POS 53: Community Mental Health Center
- POS 62: Comprehensive Outpatient Rehabilitation Facility (CORF)
Coding Guidelines Gor Psychiatric Services
Psychotherapy codes that include an E/M component (CPT 90805, CPT 90807, CPT 90809, CPT 90811, CPT 90813, CPT 90815, CPT 90817, CPT 90819, CPT 90822, CPT 90824, CPT 90827 and CPT 90829) are payable only to Doctors of Medicine (MDs), Doctors of Osteopathy (DOs), qualified CNSs, NPs and PAs. Each element of these services (therapy and E/M) must be reasonable and necessary and should be documented in the patient’s records.
Psychiatrists, clinical psychologists, NPs, PAs and CSWs may bill codes CPT 90801, CPT 90802, CPT 90804, CPT 90806, CPT 90808, CPT 90810, CPT 90812, CPT 90814, CPT 90816, CPT 90818, CPT 90821, CPT 90823, CPT 90826, CPT 90828, CPT 90845, CPT 90846, CPT 90847, CPT 90853, CPT 90857 and CPT 90880.
Clinical Nurse Specialists (CNSs) may bill codes CPT 90801, CPT 90802, CPT 90804–90829, CPT 90846, CPT 90847, CPT 90853 and CPT 90857. Psychoanalysis (CPT 90845) is not covered for CNSs.
Psychiatric nurse practitioners may bill for codes CPT 90801, CPT 90802, CPT 90804, CPT 90805, CPT 90806, CPT 90807, CPT 90808, CPT 90809, CPT 90810, CPT 90811, CPT CPT 90812, CPT 90813, CPT 90814, CPT 90815, CPT 90816, CPT 90817, CPT 90818, CPT 90819, CPT 90821, CPT 90822, CPT 90823, CPT 90824, CPT 90826, CPT 90827, CPT 90828, CPT 90829, CPT 90846, CPT 90847, CPT 90849, CPT 90853 and CPT 90857 if they are trained and authorized to perform these psychiatric services.
Codes for psychotherapy with E/M services (CPT 90805, CPT 90807, CPT 90809, CPT 90811, CPT 90813, CPT 90815, CPT 90817, CPT 90819, CPT 90822, CPT 90824, CPT 90827, CPT 90829) should be used when psychotherapy is performed and there is an appropriate level of E/M service that is medically necessary and separately performed. For example, the E/M service could involve medical diagnostic evaluation, drug management, physician orders, and/or interpretation of laboratory tests or other diagnostic studies and observations.
Similar services on the same day are not permitted to multiple providers in the same specialty for the same diagnosis.
Medicare will not accept psychotherapy procedure codes 90804–90829 billed on the same day of service as an E/M service by the same provider.
Interactive psychotherapy codes CPT 90810–90815 and CPT 90823–90829 should not be billed on the same dates of service as regular psychotherapy codes CPT 90804–90809 or CPT 90816–90822.
Procedure codes CPT 90808, CPT 90809, CPT 90814, CPT 90815, CPT 90821, CPT 90822, CPT 90828 and CPT 90829 represent services lasting approximately 75 to 80 minutes. The provider must document in the patient’s medical record the medical necessity of these services and define the extended services. Medicare anticipates that these extended services will be used in times of exceptional need.
Psychotherapy services are never covered for severe and profound mental retardation (ICD-9-CM codes 318.1 and 318.2).