New CPT Billing Codes for Psychotherapy Go Into Effect January 1

The CPT code numbers that mental health professionals use for billing psychotherapy services to insurance carriers will change on January 1, 2013. In addition to the code changes, Medicare reimbursement rates will also be revised. The AMA will publish the new codes and rates later this fall.

The American Psychological Association’s Practice Central Web site outlines some of the anticipated changes, which include:

1.  Outpatient and inpatient psychotherapy codes will be replaced by a single set of codes that can be used in both settings.
2.  The new psychotherapy codes will have specified times rather than ranges:

  • 30 minutes, not 20-30 minutes
  • 45 minutes, not 45-50 minutes
  • 60 minutes, not 75-80 minutes

3.  The single psychiatric diagnostic evaluation code will be replaced by two codes: one for a diagnostic evaluation and the other for a diagnostic evaluation with medical services.

What practical steps do you need to take now in order to prepare for these changes? According to the American Psychiatric Association, the pharmacologic management code will no longer exist, so it is important for practitioners to start familiarizing themselves with the medical evaluation and management (E/M) codes for medication management. Practitioners should also review any contracts they have with insurers to make sure that the contracts don’t limit them to specific codes in the psychiatry section that may be replaced as of January 1. HIPPA requires that insurers use current CPT codes, so these companies should be updating contracts in the coming months.

For the latest information about these changes and how they may affect your practice, visit the American Psychological Association’s Practice Central Web site or call its Practitioner Helpline at 1.800.374.2723.

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