Every journey towards mental wellness is a unique story. These are told in small, deliberate steps. However, for some, that story unfolds with one therapy session at a time. How? Because each visit builds on the last to help them overcome trauma, anxiety, or simply find their footing again. These brief interactions have a profound impact on individual lives.
However, healthcare providers often struggle to accurately document and bill these vital psychotherapy sessions (CPT code 90832). But not any more! With this guide, things will take a positive turn because we will discuss everything from clinical scenarios to applicable modifiers and billing guidelines.
Thus, if you are tired of leaving money on the table for psychotherapy sessions, read this guide till the end!
CPT Code 90832 – Description
CPT code 90832 is a timed procedural code. It covers an individual psychotherapy session that lasts between 16 minutes and 37 minutes. For context, psychotherapy involves a series of techniques to help people experiencing various emotional and mental health challenges.
Scenarios Where CPT Code 90832 is Applicable
The following are some real-world clinical scenarios where CPT 90832 applies:
Adolescent with Adjustment Disorder
A research study found that in the United States, 14% of pediatric psychiatry consultations resulted in an adjustment disorder diagnosis.
So, picture a 15-year-old male with an adjustment disorder because of a recent move and school change. He visits a psychiatrist for a scheduled 35-minute psychotherapy session.
During the session, the therapist helps the patient process feelings of isolation and homesickness. Moreover, the provider works with the teenager to identify potential social activities at the new school.
Here, CPT code 90832 applies.
Patient with Generalized Anxiety Disorder (GAD)
Before discussing another clinical scenario, let’s examine some key statistics related to the prevalence of GAD in the U.S.
It affects 3.1% (6.8 million) adults in the U.S., yet only 43.2% of these affected individuals receive treatment.
That’s not all, women are twice as likely to have GAD as men. Besides, this mental illness often accompanies major depression.
With that said, suppose a 24-year-old female patient with GAD comes for a focused 30-minute psychotherapy session. She has been experiencing severe anxiety due to an upcoming work presentation.
Thus, the provider works with her on a specific cognitive-behavioral technique. This therapy session aims to challenge and reframe the patient’s negative thoughts about failure into more realistic and manageable ones.
The therapist will report CPT code 90832 to bill for the services.
Focused Trauma Therapy
Did you know approximately 6 out of every 100 individuals experience post-traumatic stress disorder (PTSD) at some point in their lives?
Now, imagine a 32-year-old male patient with PTSD. He comes for a scheduled 25-minute psychotherapy session. This session aims to reinforce skills to manage anxiety and flashbacks.
Therefore, during the visit, the therapist helps the patient practice a specific grounding exercise, e.g., the 5-4-3-2-1 technique. For context, this exercise motivates the patient to notice the following:
- Five things you see around you.
- Four things you can touch around you.
- Three things you hear.
- Two things you can smell.
- One thing you can taste.
This exercise helps the patient regain control during a high-anxiety episode.
Here, CPT code 90832 applies.
Applicable Modifiers for CPT Code 90832
Here’s a list of some of the applicable modifiers for accurately billing psychotherapy sessions:
Modifier 59
What happens when the same therapist conducts family psychotherapy with the patient present (CPT 90847) on the same day as an individual psychotherapy session (CPT 90832) for the same patient?
You append modifier 59 to CPT code 90832 to indicate that it is a distinct, separately identifiable care service. This modifier will help you bypass bundling edits and ensure accurate reimbursement.
Modifiers 95 & GT
CPT code 90832 is a telehealth-approved service. It means that the therapist can perform the psychotherapy via a real-time telecommunication audio/video system. When this happens, you must report CPT 90832 with modifier 95 or GT to indicate that the physician rendered care services through a telehealth encounter.
Note: Which modifier to add (95 or GT) depends on specific payer policies.
Modifiers AF, AJ, AH, or HP
While billing for psychotherapy services, you must also specify the educational level of the physician. Therefore, you must append one of the following modifiers:
- AF – It means a psychiatrist (MD) conducted the psychotherapy session.
- AJ – It represents that a licensed clinical social worker (LCSW) performed the service.
- AH – It highlights that the performing physician was either a clinical psychologist or has a doctorate-level degree (Ph.D. or PsyD).
- HP – It indicates that a psychologist or a healthcare practitioner with a doctorate-level degree performed psychotherapy (Ph.D. or PsyD).
You may note that modifiers AH and HP represent the same thing. Therefore, you must familiarize yourself with payer-specific policies to understand which of these modifiers the relevant payer accepts.
Modifier KX
You may encounter a scenario where a patient’s psychotherapy services exceed the limit specified in the insurance plan. When this happens, report CPT code 90832 with modifier KX. It highlights to the payer that the rendered care services are medically necessary, even if beyond the allowed threshold.
CPT Code 90832 – Billing & Reimbursement Guidelines
Discussed below are the essential billing and reimbursement guidelines related to CPT 90832:
Meet the Documentation Requirements
Documentation completeness and accuracy are key to timely claim processing. Thus, your session notes must include the following:
- Mention the start and end times of the psychotherapy session. It is essential since the session must fall within the duration limit of 16-37 minutes, as the CPT code 90832 descriptor clearly states.
- Comprehensively explain the patient’s symptoms and conditions. Also, mention why the psychotherapy session was required to support its medical necessity.
- Mention the specific therapeutic techniques and interventions the therapist employed during the session.
- Include the progress notes detailing the patient’s response to the psychotherapy and treatment goals.
Do Not Report CPT Code 90832 when the Session is Longer than 37 Minutes
The CPT 90832 descriptor clearly states that it covers psychotherapy sessions that are at least 16 minutes and a maximum of 37 minutes long. So, what happens when the duration exceeds 37 minutes? Can you report multiple units of this procedural code?
No, you cannot. Because there are other codes available for this specific reason. The details of these are listed below:
- CPT 90834 – Psychotherapy session that is 38 minutes to 52 minutes long.
- CPT 90837 – Psychotherapy session that lasts for a minimum of 53 minutes or more.
Avoid Reporting CPT Code 90832 with an E/M Service
You cannot bill CPT 90832 with an evaluation and management (E/M) code. So, what happens when a therapist performs an E/M service and psychotherapy for the same patient on the same day? You report the E/M code (99202-15) as the primary code, then add the relevant psychotherapy add-on code (e.g., +90833).
Summary
Phew! That was a lot to digest in one go. Don’t worry, before concluding this guide, we will quickly revisit the key takeaways.
First, we explained the CPT code 90832 descriptor. It covers individual psychotherapy session that lasts for 16 minutes to 37 minutes.
Next, we shared a few real-world clinical scenarios where this code may be used. These include focused trauma therapy and treating patients with GAD or adolescents with adjustment disorders.
We also listed down and explained some of the applicable modifiers for CPT 90832, including 59, 95, GT, AF, AH, AJ, HP, and KX.
Finally, we discussed the essential billing and reimbursement guidelines. Hopefully, all this information will help you accurately bill for psychotherapy sessions, leading to a healthier revenue cycle. However, if you struggle and need professional help, consider outsourcing mental health billing services to professionals like MediBillMD.
