CPT Code 90838: Understanding Psychotherapy Codes
Introduction
The Current Procedural Terminology (CPT) code set is a standardized medical code set maintained by the American Medical Association (AMA). It is used to report medical, surgical, and diagnostic procedures. Psychotherapy codes are a subset of CPT codes that are used to report psychotherapy services. Before we understand the CPT code 90838, let’s understand the basics of psychotherapy codes.
Types of Psychotherapy Codes
There are two main types of psychotherapy codes:
Time-based Codes
These codes are based on the amount of time spent providing psychotherapy services. The time-based psychotherapy codes are 90832 (30 minutes), 90834 (45 minutes), and 90837 (60 minutes).
Add-on Codes
These codes are used when psychotherapy is provided in the same encounter as an evaluation and management (E/M) service. The add-on psychotherapy codes are +90833 (30 minutes), +90836 (45 minutes), and +90838 (60 minutes).
When to Use Individual Psychotherapy Codes?
Individual psychotherapy codes are used to report psychotherapy services that are provided to an individual patient. These codes can be used by a variety of providers, including psychiatrists, psychologists, social workers, and therapists.
Understanding CPT Code 90838
CPT code 90838 is an add-on code that is used to report 60 minutes of individual psychotherapy. This code can be used when psychotherapy is provided in the same encounter as an E/M service. Psychotherapy with E/M services is now reported with codes for E/M services plus a psychotherapy add-on code, +90833, +90836, and +90838.
- Code ‘exact’ time (in minutes) Actual Time Range (in minutes)
- 90832, +90833 30 16-37
- 90834, +90836 45 38-52
- 90837, +90838 60 At least 53
Psychotherapy times are for face-to-face services with the patient and/or family member. The patient must be present for all or some of the service. In reporting, choose the code closest to the actual time (i.e., 16-37 minutes for 90832 and 90833, 38-52 minutes for 90834 and 90836, and 53 or more minutes for 90837 and 90838). Do not report psychotherapy of less than 16 minutes duration.
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