CPT Code 90832: What is it, When to use it
Guide
Current Procedural Terminology (CPT) codes serve as the universal language for describing medical, surgical, and diagnostic services. Mastering these codes is an essential aspect of running a successful.
In this guide, we take a comprehensive look at CPT Code 90832, wits its application, billing intricacies, and best practices for implementation. We also cover the use of AI Therapy Note tools to automatically write your notes along with the right CPT code. For a comprehensive guide to all CPT codes with cheat sheet and examples, refer here.
What is CPT Code 90832?
CPT Code 90832 represents a 30-minute individual psychotherapy session. However, it's important to note that the actual time range for this code is 16 to 37 minutes. This flexibility allows for natural variations in session length while still maintaining a category distinct from longer therapy sessions.
Key Characteristics of CPT Code 90832
Session Length: 16-37 minutes
Therapy Type: Individual psychotherapy only
Patient Presence: Patient must be present (physically or via telehealth, real-time)
Focus: Psychotherapy services only (not for medication management or evaluation)
Who Can Use CPT Code 90832?
This code can be used by a variety of mental health professionals, including:
Licensed Clinical Psychologists (PsyD or PhD)
Licensed Clinical Social Workers (LCSW)
Licensed Professional Counselors (LPC)
Licensed Mental Health Counselors (LMHC)
Licensed Marriage and Family Therapists (LMFT)
Psychiatric Providers with Medical Licenses
It's important to note that while pre-licensed therapists working under supervision may be able to use this code, they often need to use specific modifiers or have their supervisor's information included on the claim. Always check your state regulations and insurance policies for specific requirements.
When to Use CPT Code 90832
Understanding when to use CPT Code 90832 is crucial for accurate billing and optimal patient care. Here are some common scenarios where this code is often used.
Brief Follow-up Sessions
After a significant event or intervention, a shorter session might be sufficient to check in with the patient and provide support. Example: A patient who recently started a new job might benefit from a brief session to discuss initial adjustments and coping strategies.
Regular Check-ins
Some treatment plans may incorporate shorter, more frequent sessions to maintain progress and prevent relapse. Example: A patient with anxiety disorder might benefit from weekly 30-minute sessions to practice and refine coping techniques.
Telehealth Platforms
Many online therapy platforms schedule 30-minute sessions as standard practice. Example: A busy professional might prefer shorter, more frequent telehealth sessions that can easily fit into their workday.
Sessions with Children or Adolescents
Younger clients often have shorter attention spans and may benefit more from briefer, focused sessions. Example: A 10-year-old with ADHD might engage more effectively in 30-minute play therapy sessions than in longer sessions.
Time-Constrained Situations
When either the therapist or client has limited availability, a 30-minute session can still provide valuable therapeutic intervention. Example: A therapist with a full caseload might offer 30-minute sessions to accommodate more patients during peak hours.
Maintenance Therapy:
Clients who have made significant progress and are transitioning out of regular therapy might benefit from shorter "check-in" sessions. Example: A client who has successfully completed cognitive-behavioral therapy for depression might schedule monthly 30-minute sessions to maintain progress and address any emerging concerns.
Crisis Intervention Follow-ups
After an initial crisis intervention session, shorter follow-up sessions might be appropriate to ensure stability and provide ongoing support. Example: Following a suicide risk assessment and safety planning session, a therapist might schedule several 30-minute follow-up sessions to monitor the client's progress and adjust the safety plan as needed.
Specialized Interventions
Some therapeutic techniques or interventions may be most effective when delivered in shorter, focused sessions. Example: A therapist using Eye Movement Desensitization and Reprocessing (EMDR) might find that 30-minute sessions are optimal for certain phases of the treatment.
When to NOT use CPT code 90832
It's crucial to remember that CPT Code 90832 is specifically for individual psychotherapy. It should NOT be used for:
Group therapy sessions (use 90853 instead)
Family or couples therapy (use 90847 or 90846)
Medication management without psychotherapy (use appropriate E/M codes)
Psychoanalysis (use 90845)
Using Modifiers with CPT Code 90832
Modifiers are two-digit codes that provide additional information about the service provided. Using the correct modifiers can ensure accurate billing and prevent claim denials. Here are some common modifiers used with CPT Code 90832:
52: Reduced Services
Usage: When a service is partially reduced or eliminated at the physician's discretion.
Example: If a session is terminated early due to patient distress or other circumstances.
59: Distinct Procedural Service
Usage: To indicate that a procedure or service was distinct or independent from other non-E/M services performed on the same day.
Example: If you provide both individual therapy (90832) and group therapy (90853) on the same day.
95: Synchronous Telemedicine Service
Usage: Indicates that the service was provided via real-time interactive audio and video telecommunications system.
Example: When providing a 30-minute therapy session via video call.
25: Significant, Separately Identifiable E/M Service
Usage: Used by medical providers to indicate that a significant, separately identifiable E/M service was provided on the same day as a procedure or other service.
Example: A psychiatrist provides both medication management (E/M service) and psychotherapy in the same visit.
HO: Master's Degree Level
Usage: Indicates that the service was provided by a therapist with a master's degree.
Example: An LCSW or LPC might use this modifier if required by the insurance company.
HP: Doctoral Level
Usage: Indicates that the service was provided by a doctoral-level provider.
Example: A psychologist might use this modifier if required by the insurance company.
Remember, the use of modifiers can vary depending on the payer. Always check with specific insurance companies for their modifier requirements.
Typical Reimbursement Rates
As of 2024, reimbursement rates for CPT Code 90832 typically fall within the following ranges:
Medicare: Approximately $75 for outpatient care and $60 for in-facility services.
Commercial Insurance: Generally between $70 and $100, but this can vary widely.
It's important to note that these are average figures and actual reimbursement can vary significantly. Always verify current rates with each insurance plan you work with, as rates can change annually.
Documentation Requirements
Proper documentation is the backbone of ethical practice, quality patient care, and successful reimbursement. For sessions billed under CPT Code 90832, your documentation should be thorough and precise. Let's explore the essential elements and best practices in more detail:
Best Practices for Documentation
Timeliness: Document immediately after the session when the details are fresh in your mind. This ensures accuracy and saves time in the long run.
Use a Consistent Format: Adopt a standard format for your notes, such as SOAP (Subjective, Objective, Assessment, Plan) or DAP (Data, Assessment, Plan). This promotes consistency and ensures you cover all necessary elements.
Automate your note writing: Use any of the AI therapy Note tools to write robust notes that capture relevant details, and also ensure your notes are done immediately after the session
Common Mistakes and How to Avoid Them
Even experienced therapists can sometimes make mistakes when it comes to using CPT Code 90832. Being aware of these common errors can help you avoid them:
Using 90832 for sessions longer than 37 minutes
Mistake: Billing 90832 for a 40-minute session
Solution: Use 90834 for sessions between 38-52 minutes.
Billing 90832 for group or family therapy
Mistake: Using 90832 for a 30-minute family therapy session
Solution: Use 90847 for family therapy with the patient present.
Not documenting start and end times
Mistake: Writing "30-minute session" without specific times.
Solution: Always document exact start and end times.
Using the code for psychoanalysis or crisis intervention
Mistake: Billing 90832 for a brief emergency session.
Solution: Use 90839 for crisis intervention.
Inconsistent use of modifiers
Mistake: Forgetting to add the -95 modifier for telehealth sessions.
Solution: Create a checklist or use EHR software that prompts for appropriate modifiers.
Overbilling by routinely using higher-paying codes
Mistake: Always using 90834 even for shorter sessions.
Solution: Accurately track session times and use the appropriate code for each session.
Neglecting to check insurance-specific requirements
Mistake: Assuming all insurance companies handle 90832 the same way.
Solution: Regularly verify coding requirements with each insurance provider.
Insufficient documentation to support the code
Mistake: Providing vague or minimal session notes.
Solution: Ensure documentation clearly justifies the use of 90832 and demonstrates medical necessity.
Comparison with Related CPT Codes
Understanding how CPT Code 90832 relates to other CPT codes is crucial for accurate billing and ensuring you're using the most appropriate code for each session. Let's explore these related codes in more detail:
CPT Code 90834: 45-Minute Psychotherapy
Time Range: 38-52 minutes
Key Differences:
Longer session duration
Typically allows for more in-depth exploration of issues
Generally reimbursed at a higher rate than 90832
When to use 90834 instead of 90832: If your session extends beyond 37 minutes, you should bill using 90834. This code is often used for standard therapy sessions where more time is needed to address complex issues or engage in more intensive therapeutic work.
CPT Code 90837: 60-Minute Psychotherapy
Time Range: 53+ minutes
Key Differences:
Significantly longer session duration
Allows for the most comprehensive therapeutic work in a single session
Typically reimbursed at the highest rate of the three individual therapy codes
When to use 90837 instead of 90832: Use this code for extended sessions lasting 53 minutes or longer. This is often appropriate for intensive therapy sessions, initial assessments, or when working through particularly complex or severe issues.
CPT Code 90847: Family/Couples Therapy with Patient Present
Key Differences:
Involves multiple participants (family members or partners)
Focus is on relationship dynamics and systemic issues
Can be used for various session lengths (typically 45-50 minutes)
When to use 90847 instead of 90832: Use this code when conducting therapy that involves the identified patient and one or more family members or partners. This code is appropriate regardless of the session length when the focus is on relational issues.
CPT Code 90846: Family Therapy without Patient Present
Key Differences:
Involves family members but not the identified patient
Used for collateral sessions or parent coaching
Can be used for various session lengths
When to use 90846 instead of 90832: This code is appropriate when you're meeting with family members of the patient without the patient present, such as in parent coaching sessions or when gathering family history.
CPT Code 90853: Group Psychotherapy
Key Differences:
Involves multiple patients in a group setting
Typically longer duration (60-90 minutes)
Billed per patient, not per group
When to use 90853 instead of 90832: Use this code for any group therapy sessions, regardless of the length of the session. Remember, you bill this code for each patient in the group, not just once for the entire group.
CPT Code 90839: Psychotherapy for Crisis
Time Range: 30-74 minutes
Key Differences:
Used for emergency situations requiring immediate intervention
Can be used with add-on code 90840 for each additional 30 minutes
832*: Use this code when providing emergency services to a patient in acute distress or experiencing a life-threatening situation. This code is not for routine therapy, even if the content is distressing.
CPT Codes 99202-99205 and 99212-99215: Evaluation and Management (E/M) Codes
Key Differences:
Used primarily by medical providers (psychiatrists, psychiatric NPs)
Include assessment of medical conditions and medication management
Can be used in conjunction with psychotherapy add-on codes
When to use E/M codes instead of 90832: These codes are appropriate when the primary focus of the session is on evaluation of medical conditions or medication management, rather than psychotherapy. They're typically used by providers who can prescribe medication.
Frequently Asked Questions (FAQ)
Can I use CPT Code 90832 for group therapy?
No, 90832 is for individual therapy only. Use 90853 for group therapy.
What if my session goes over 30 minutes?
If the session lasts 38-52 minutes, use code 90834. For 53+ minutes, use 90837.
How often can I bill using CPT Code 90832?
There's no set limit, but the frequency should align with the patient's treatment plan and medical necessity.
Can I use this code for telehealth sessions?
Yes, but you may need to add the -95 modifier. Check with the specific payer for their telehealth billing requirements.
What's the difference between CPT Code 90832 and an E/M code?
90832 is for psychotherapy only. Evaluation and Management (E/M) codes are used for medical management, including psychiatric medication management.
Conclusion
Understanding and correctly implementing CPT Code 90832 is a crucial skill for mental health professionals offering 30-minute therapy sessions. This code allows for flexibility in treatment planning and can be particularly useful for certain client populations or treatment modalities.
Remember these key points:
CPT Code 90832 is for individual psychotherapy sessions lasting 16-37 minutes.
Proper documentation is crucial, including exact start and end times.
Be aware of related codes and when to use them instead of 90832.
Use modifiers correctly to provide additional information about the service.
Stay updated on reimbursement rates and insurance policies.
Implement best practices to ensure accurate billing and high-quality patient care.
By mastering the use of CPT Code 90832, you can ensure that you're fairly compensated for your services while providing flexible, patient-centered care. Continue to educate yourself on coding changes, maintain thorough documentation, and always prioritize ethical billing practices. With these strategies in place, you can confidently incorporate 30-minute sessions into your practice, expanding your ability to meet diverse patient needs and optimize your clinical effectiveness.