Top 10 Mental Health CPT Codes
Searching for a list of current procedural terminology codes (aka CPT codes)? Or, perhaps you’re looking for the top mental health CPT codes? You’ve come to the right place, because we’ll share some fast facts and the most common mental health CPT codes list.
To gain insight into U.S. behavioral health trends, SimplePractice identified the 20 most frequently used CPT codes used by mental health practitioners when billing health insurance.
This list of the most common mental health CPT codes used by solo and small group behavioral health providers reveals most common mental health treatments and services clinicians provided to clients in the U.S. over the previous year.
We gathered the top mental health mental health CPT codes list from more than 200,000 U.S.-based practitioners who use SimplePractice’s HIPAA-compliant therapist electronic health record (EHR) to manage their practices, minimize administrative work, and simplify insurance claims for therapists.
What is a current procedural terminology code (aka CPT code)?
Current procedural terminology codes (aka CPT codes) are developed by the American Medical Association (AMA). They are a standardized coding system for describing medical services and treatments.
Put simply, these codes refer to the actions a health care provider took during an interaction with or on behalf of their client or patient.
Similarly to ICD codes, CPT codes are updated annually, and are used by both federal healthcare programs like Medicaid and Medicare, as well as private insurers, to describe services, to track healthcare utilization, and to identify services to determine payment amounts.
Using the proper codes is vital to getting paid in full and avoiding insurance audits—specifically for therapists who are on panels or who provide superbills to clients.
Different CPT code categories
There are three different types of CPT codes.
Most healthcare providers use the five-digit CPT codes in Category I. Because these codes identify specific, well-established procedures, this category of codes is used the most often.
With a few exceptions, U.S. insurers generally must pay for Category I procedures, as long as they’re performed by a qualified health professional when they’re medically necessary to treat a clients’ condition.
Category II codes are used to gather information about quality of care and performance measurement, and they’re not required for billing purposes.
Category III codes are used for newer procedures and technologies and were created for data collection and assessment, and in some cases, for payment of new services that don’t meet the criteria for Category I codes.
Top-billed mental health CPT codes
This mental health CPT codes report shows the most frequently billed CPT codes used by behavioral health practitioners.
From this list of current procedural terminology codes, we are offered a glimpse into the common mental health treatments and services used by clinicians working in the U.S. during the past year.
Perhaps it’s not surprising that the most-billed CPT code in America was for 60-minute psychotherapy sessions.
When looking at the top CPT codes, psychotherapy—both in-person and telehealth video therapy sessions of varying lengths appear several times in the top ten mental health services.
Rank | Code | Description |
1 | 90837 | Psychotherapy, 60 mins with patient |
2 | 90834 | Psychotherapy, 45 mins with patient |
3 | 90791 | Psychiatric diagnostic evaluation |
4 | 90847 | Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes |
5 | 90834-95 | Psychotherapy 45 min, telehealth |
6 | 90853 | Group psychotherapy (other than of a multiple-family group) |
7 | 90832 | Psychotherapy, 30 minutes with patient |
8 | 90837-95 | Psychotherapy, 60 mins, telehealth modifier |
9 | 97803 | Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes |
10 | 99214 | Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making |
The CPT codes psychotherapy time rule
The following three psychotherapy CPT codes are time-based codes:
90832 (30 mins psychotherapy)
90834 (45 mins psychotherapy)
90837 (60 mins psychotherapy)
The time for each of these psychotherapy codes is described as time spent with the client and/or their family.
Although the code is time-specific, clinicians do have some flexibility.
For instance, even though 90832 is for a 30 minute session, you can bill that code for sessions that have a total duration of 16-37 minutes.
If you are billing time-based codes, you should always make sure you confirm the total duration each code is billable for.
Changes to CPT codes in 2022
New CPT codes are released each year to keep up with new developments in the healthcare industry.
The annual update for 2022 included a number of changes to adapt to the COVID-19 pandemic.
Part of the update is a series of 15 vaccine-specific codes meant to efficiently report and track immunizations and administrative services during the pandemic.
There were 249 new codes, 63 deletions, and 93 revisions to the 2022 CPT code set related to COVID-19 reporting.
Aside from these updates, there were additional changes made to respond to the fast pace of digital healthcare services as that industry continues to evolve. Specifically, 5 new CPT® codes were created (98975, 98976, 98977, 98980, and 98981) to report therapeutic remote monitoring.
You can visit the AMA’s website to learn more about the updating process and changes being made in 2022.
Since CPT codes are used across the entire healthcare system, there will likely be codes and updates that don’t apply to you as a mental health provider.
Still, it’s a good idea to review the updates as they are released, to make sure you’re using the most accurate code for your service or that you’re not trying to bill a deleted code.
How CPT code updates impact your practice
Since CPT codes are used across multiple healthcare fields, there’ll probably be numerous codes in each update that don’t apply to your billing.
That said, you do want to review the annual updates carefully—if you use a deleted code that’s no longer recognized, or try to use an old version of a code, the reimbursement for that service may be denied.
The world of insurance billing for private practice can get complicated. To avoid getting stuck in endless billing conversations, set aside a block of time to review all the new information thoroughly.
How SimplePractice streamlines running your practice
SimplePractice is HIPAA-compliant practice management software with everything you need to run your practice built into the platform—from booking and scheduling to insurance and client billing.
If you’ve been considering switching to an EHR system, SimplePractice empowers you to run a fully paperless practice—so you get more time for the things that matter most to you.
Try SimplePractice free for 30 days. No credit card required.
READ NEXT: How to Look Up CPT Codes
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