The health and behavior codes follow.ĩ0834 Psychotherapy, 45 minutes with patient and/or family memberĩ0837 Individual psychotherapy, 60 minutesĩ6150 This code applies to health and behavior assessment (e.g., health focused clinical interviews, behavioral observations, psychophysiological monitoring, health-oriented questionnaires). Of course one must engage in the activities that fit the definition for these specific codes. These new codes, 96150-96155, are used for health and behavior assessments and interventions where it is not necessary to make a psychological diagnosis (e.g., DSM IV). Prior to their creation, psychological interventions could not be provided to those with medical or physical problems unless there was a psychological diagnosis to help verify “medical necessity.” Their use does not require that there be a psychological diagnosis. Health and Behavior Assessment/Intervention Codes The new CPT Health and Behavior Assessment/Intervention codes were basically developed to recognize the work of professionals, like psychologists, with physical health problems. The code for psychotherapy without biofeedback is discussed later under the section on Other Codes. Of course not every insurance company pays for this service or they may pay for it within one client coverage policy contract and not within another, adding to the coding, billing, and reimbursement confusion.
Anyone who can legally provide psychological/mental health services within their state can use the 90875 or 90876 codes. The only difference between the 90875 and 90876 is the length of the treatment session, i.e., 20-30 minutes versus 45-50 minutes.
It must be face-to-face with the patient and session length is approximately 20-30 minutes.ĩ0876 The definition for this code is the same as for 90875, but the session length is approximately 45-50 minutes in duration. It includes EMG biofeedback, and/or manometry.ĩ0875 This code applies to individual psychophysiological therapy that incorporates biofeedback training by any modality with psychotherapy (e.g., insight oriented, behavior modifying or supportive psychotherapy). 90901 This code applies to biofeedback training using any modality.ĩ0911 This code applies to biofeedback training of the perineal muscles and/or the anorectal or urethral sphincter.