CPT Code 90832 Description & Reimbursement Guidelines

It is a fact that no healthcare service provider wants delayed reimbursements for their services. But why and how do these delays occur? The main reason is the wrong use of the CPT code for the services given. 

This blog will deeply analyze the appropriate use of CPT code 90832, a psychotherapy code. Mental health is a common problem all over the world. Around 1 in 8 people suffer from mental health issues. A psychotherapist helps patients to regulate their emotions, manage their behavior, and deal with mental health disorders. 

Let’s further understand how you, as a psychotherapist, can use CPT code 90832 for your services. 

CPT Code 90832 Description

Starting with the basic description of the CPT code 90832:

This code refers to the “individual psychotherapy services for a patient, generally for 30 minutes only.”

However, the specific duration this code covers is 16-37 minutes. Hence, the talk therapy reported by code 90832 is shorter than conventional sessions of 45 or 60 minutes. 

It is important to note that psychiatrists usually need to pair evaluation and management (E/M) codes and psychiatric diagnostic evaluation codes. However, since CPT code 90832 covers psychotherapy or a treatment rather than a diagnostic procedure, it can be reported without any E/M service codes. 

Appropriate Use Cases for CPT Code 90832

The following real-life scenarios will help you better understand the application of CPT code 90832.

Quick Therapy Sessions 

In the first scenario, let’s consider a boy who had taken regular therapy sessions in the past and is currently going through a hard phase where he is struggling to channel his emotions. He decides to have a quick therapy session to have better clarity about how to deal with this situation while staying emotionally strong. A psychotherapist provides him with a quick 35-minute session and equips him with some techniques to regulate his emotions. Since the session is within the 16 to 37-minute timeframe, he can claim 1 unit of CPT code 90832 for his services. 

Psychoeducation

Suppose a young girl who has been suffering from anxiety goes to a clinic and tells the psychotherapist about how her heartbeat increases in stressful situations, and she often feels short of breath. The psychotherapist carefully listens to her situation and educates her about some tips to manage her anxiety, such as breathing exercises. The total interaction lasts half an hour. Therefore, the psychotherapist will apply CPT code 90832.  

Follow-Ups 

Lastly, imagine that you, as a psychotherapist, have given an assignment to one of your patients, or you have to wind up their regular therapy sessions. To bid farewell or check on their progress, you conduct a quick in-person session with the patient for 20-30 minutes. In this case, you can apply CPT code 90832. 

Modifiers to Append with CPT Code 90832

Providers can append modifiers to give additional context for the services (under special circumstances) that the CPT codes do not cover. The following are some modifiers that are usually appended to CPT code 90832. 

Modifier 59

A service provider can append this modifier if he has performed distinct or non-E/M services on the same day for the same patient. 

Modifier 95

Modifier 95 is used when a provider performs synchronous telemedicine services through an audio or visual platform. 

Nowadays, most therapists provide audio or video psychotherapy services to their patients, so they can append this modifier with CPT code 90832 to explain that the talk therapy was a telemedicine service. 

Reimbursement Guidelines for CPT Code 90832

Here are a few billing guidelines for CPT code 90832, which will protect your practice from claim denials. 

Ensure Appropriate Use of CPT Code

If you are a psychotherapist and you want fair reimbursement for your services. You must use the CPT code 90832 for a short 30-minute therapy session only. The maximum estimated time limit is 37 minutes. You can not bill for this code at the 38th minute because it will change the code and may impact the billing process. 

Maintain Complete Clinical Notes

Along with the therapy session, a psychotherapist must maintain detailed clinical notes for insurance payers, which must include:

• The starting and ending times of the session. 
• The therapeutic techniques he used on the patient such as cognitive behavioral therapy, psychodynamic therapy, and dialectical behavior therapy.
• The issues that were discussed.
• The treatment goals that he set with the patient. 
• The steps that he took to help the patient manage mental and behavioral challenges.

Fulfill the Documentation Requirements 

Proper and accurate documentation is essential for medical billing, specifically psychotherapy services. It helps insurance payers know why, when, and to whom the service was provided, and the necessity of the service. 

Compliance with Regulations

Psychotherapists must conduct therapy sessions in compliance with HIPAA or other regulations. For example, if a psychotherapist is conducting a telehealth session, they must conduct it through HIPAA-compliant audio or video platforms. 

Final Thoughts on CPT Code 90832

This blog has thoroughly covered the specifics of CPT code 90832. We have discussed its uses, limitations, applicable modifiers, and the billing and documentation guidelines that a psychotherapist must know. The code deals with short therapy sessions of only 30 minutes without evaluation and management. 

If you are still unclear about the code’s usage and billing guidelines, you can acquire professional mental health billing services for effortless claim submissions. 

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