What Is the Psych Eval CPT Code?
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Looking for psych eval CPT codes? This article includes a list of mental health CPT codes and information on when it’s appropriate to use the CPT code initial psychiatric evaluation.
As a behavioral health clinician, it’s key to understand how to diagnose and evaluate clients using psych eval CPT codes as well as mental health CPT codes in general.
Additionally, when meeting new clients for the first time, it’s imperative to know about the CPT code’s initial psychiatric evaluations so you can screen for relevant symptoms, while also determining if you’re equipped to care for the clients’ needs.
The healthcare coding system is complex. You’ll need to know the difference between CPT vs. HCPCS codes and when to use the psych eval CPT code, as opposed to other CPT codes for mental health.
In this article, you’ll find out how and when to use the CPT code initial psychiatric evaluation and key differences between CPT codes. We also provide a handy list of CPT codes to save to your electronic health record (EHR)—so you can quickly reference it without any need to scour the web for information.
What are CPT codes?
Current Procedural Terminology (CPT) is a term created by the American Medical Association (AMA) to describe healthcare procedures, surgery, and diagnostic services. Healthcare professionals around the globe use CPT codes to ensure standardized language, accurate reporting, and data tracking.
The CPT coding system is used by all clinical providers, including behavioral health therapists. The primary reasons for using CPT codes are for insurance reimbursement (public and private) and treatment planning. Even if a clinician doesn’t accept insurance they can still provide clients with a superbill containing CPT codes to submit to insurance for reimbursement.
There are three categories of CPT codes:
- Category I: Describes common medical procedures (also called CPT-4 codes)
- Category II: Records performance and quality, and services, products, and supplies that are not otherwise described in Category I CPT codes, such as medical equipment and supplies, ambulatory services, and prosthetics
- Category III: These codes describe new and emerging technology, procedures, and services, however, they are not widely used
You may also be familiar with HCPCS codes, which stands for Healthcare Common Procedure Coding System. This coding system was designed by the Centers for Medicare and Medicaid Services (CMS). It is used by providers to classify certain procedures and services mainly provided to clients with Medicare or Medicaid.
What are psych eval CPT codes?
There are numerous psych eval CPT codes, and the one you use will depend on the type of clinician, the setting, and whether the service was accompanied by psychotherapy.
The following examples illustrate common psych eval CPT codes and when they are used:
- 90838 CPT code: Used for 60 minutes of psychotherapy with evaluation and management service (E&M), and one of the most common evaluation and management codes used by therapists.
- 90791 CPT code: Initial psychiatric evaluation, which is used when no other medical services are provided.
- 90792 CPT code: Psychiatric diagnostic evaluation with medical services.
- 90882 CPT code: Less commonly used for “other psychiatric services or procedures” or environmental manipulation or management.
- Note: This CPT code is not billable to CMS.
Other mental health CPT codes
The following CPT codes are used by mental health clinicians in both inpatient and outpatient settings:
Inpatient psychiatric CPT codes
- CPT code 99221: Inpatient evaluation and management of a low complexity patient, of 30 minutes or less
- CPT code 99222: Inpatient evaluation and management with moderate complexity, of 50 minutes
- CPT code 99223: Inpatient evaluation and management with extensive complexity, of 70 minutes
Outpatient psych eval CPT codes
- CPT code 90838: 60-minute psychotherapy with E&M service
- CPT code 90791: Psychiatric evaluation
- CPT code 90792: Psychiatric diagnostic evaluation with medical services
- CPT code 99202: Outpatient E&M for new patient with minimal concerns and assessment and 15 to 29 minute duration
- CPT code 99203: Outpatient E&M for new patient with low complexity, limited assessment and 30 to 44 minute duration
- CPT code 99204: Outpatient E&M for new patient with moderate complexity, moderate assessment, and 45 to 59 minute duration
- CPT code 99205: Outpatient E&M for new patient with high complexity, extensive assessment, and 60 to 74 minute duration
Other common mental health CPT codes
- CPT code 90832: 30-minute psychotherapy session
- CPT code 90837: 60-minute psychotherapy session
- CPT code 90834: 45-minute psychotherapy session
- CPT code 90846: 50-minute family therapy session (without client present)
- CPT code 90847: 60-minute family therapy session (with client present)
- CPT code 90839: 60-minute crisis psychotherapy
- CPT code 90853: Group psychotherapy (not time-based)
- CPT code 90857: Interactive group psychotherapy
- CPT code 90875: Other psychiatric services or procedures
Clinicians may also add a CPT code modifier to provide additional information, such as:
- Modifier UT: Describes attending to a patient in crisis
- Modifier GT: Defines a telehealth session using audio and video
- Modifier 25: Used to describe a separate evaluation and management service
- Note: You can only attach modifier 25 to codes 99201 to 99215 and 99341 to 99350.
- Modifier 59: Denotes another service completed with the client on the same day (excludes evaluation and management).
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