Major Changes to CPT Codes for Psychiatry in 2013
- Changes to the current diagnostic evaluation code (90801) is split into two codes which differentiates if a medical workup was part of the evaluation or not.
- Psychotherapy codes are now keyed to three levels of time spent with the patient (30 minutes, 45 minutes, and 60 minutes), and inclusion of “add-on” codes when psychotherapy is provided in conjunction with evaluation and management (E/M) work (for example, medication management).
- The pharmacologic management code (90862) has been eliminated and replaced with existing E/M codes (99XXX series codes) . This change should benefit psychiatrists by permitting them to use an E/M code that reflects the medical and psychiatric complexity of the patient and by allowing use of the psychotherapy add-on codes in conjunction with an E/M code.
- There is a new add-on code for “interactive complexity” which replaces the current separate codes for interactive evaluation psychotherapy. This can include situations in which there is a need to manage maladaptive communication among participants in therapy, for example, when caregivers’ emotions or behaviors interfere with implementing the treatment plan, or when there is evidence of a sentinel event that mandates a report to third parties. This add-on code can be used in conjunction with an initial evaluation, psychotherapy, and group psychotherapy.
- There is a new psychotherapy code for a patient “in crisis.” This code can be used when a practitioner performs an urgent assessment and history of a crisis state, a mental status exam, and a disposition.This may include mobilization of resources to defuse the crisis and restore safety and implementation of psychotherapeutic interventions to minimize the potential for psychological trauma. When a crisis encounter goes beyond 60 minutes, an add-on code for each additional 30 minutes can be used. Psychiatrists have the option of billing an E/M code to describe this work as well.
Additional information about the CPT code changes can be found on APA’s Web site at www.psychiatry.org/cptcodingchanges.