Psychotherapy
Individual Therapy

90845 – Psychotherapy Service

CPT code 90845 represents a distinct mental or behavioral health service, including evaluation, therapy, or care coordination.

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What is CPT

90845

?

90845 is a specific CPT code utilized in the realm of psychotherapy, particularly focused on individual therapy sessions. This code is essential for billing purposes within mental health services, and understanding its correct application is crucial for healthcare providers. In this entry, we will delve into the clinical purpose of CPT code 90845, outline documentation expectations, and discuss payer considerations to ensure compliance. Providers are encouraged to meticulously align their clinical notes with evidence-based interventions. It is vital to clearly document treatment goals, the interventions employed during the session, and measurable progress made by the patient. In instances where the code is time-based, precise recording of start and stop times is necessary to substantiate the duration billed and to comply with payer requirements.

Documentation Tips

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At a Glance

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Billing Examples

A clinician may conduct a therapy session focused on Cognitive Behavioral Therapy (CBT) to address a patient's panic disorder symptoms. During the session, the clinician would employ specific CBT techniques such as cognitive restructuring and exposure exercises. The clinician documents the interventions utilized, the patient’s emotional responses, and progress towards established treatment goals. If the session lasts for 45 minutes, the appropriate billing should reflect this duration with the correct time-based psychotherapy code. For instance, if the clinician decides to extend the session to 60 minutes to provide additional support, it is crucial to bill for the actual face-to-face time spent with the patient, adhering to the guidelines set for time-based coding.

Compliance Guidelines

  • Always verify payer coverage and authorization requirements prior to billing for services rendered.
  • Ensure that documentation supports medical necessity and that services are directly linked to appropriate ICD-10 diagnoses.
  • Utilize correct modifiers, such as 95 for telehealth services, as mandated by payers.
  • Avoid upcoding; select the code that accurately reflects the documented time and level of service provided.
  • Conduct periodic audits of billing practices and documentation to identify areas for improvement and minimize claims denials.

Common ICD-10 Codes

Helpful links for mental health billing and documentation

  • F32.0 - Major depressive disorder, single episode, mild
  • F41.1 - Generalized anxiety disorder
  • F33.1 - Major depressive disorder, recurrent, moderate
  • F43.10 - Post-traumatic stress disorder, unspecified
  • F41.9 - Anxiety disorder, unspecified
  • F34.1 - Dysthymic disorder

Additional Resources

Helpful links for mental health billing and documentation

Related CPT Codes

Helpful links for mental health billing and documentation

90838 – Psychotherapy Service
CPT code 90838 represents a distinct mental or behavioral health service, including evaluation, therapy, or care coordination.
90836 – Psychotherapy Service
CPT code 90836 represents a distinct mental or behavioral health service, including evaluation, therapy, or care coordination.
90845 – Psychotherapy Service
CPT code 90845 represents a distinct mental or behavioral health service, including evaluation, therapy, or care coordination.
90840 – Psychotherapy Service
CPT code 90840 represents a distinct mental or behavioral health service, including evaluation, therapy, or care coordination.
90839 – Psychotherapy Service
CPT code 90839 represents a distinct mental or behavioral health service, including evaluation, therapy, or care coordination.
90849 – Psychotherapy Service
CPT code 90849 represents a distinct mental or behavioral health service, including evaluation, therapy, or care coordination.
90853 – Psychotherapy Service
CPT code 90853 represents a distinct mental or behavioral health service, including evaluation, therapy, or care coordination.
90847 – Psychotherapy Service
CPT code 90847 represents a distinct mental or behavioral health service, including evaluation, therapy, or care coordination.
90834 – Psychotherapy, 45 Minutes with Patient
90846 – Psychotherapy Service
CPT code 90846 represents a distinct mental or behavioral health service, including evaluation, therapy, or care coordination.
90837 – Psychotherapy, 60 Minutes with Patient
CPT code 90837 represents a distinct mental or behavioral health service, including evaluation, therapy, or care coordination.
90832 – Psychotherapy, 30 Minutes with Patient
CPT code 90832 represents a distinct mental or behavioral health service, including evaluation, therapy, or care coordination.

Got questions? We’ve got answers.

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Q1: What is the primary purpose of CPT code 90845?

A: CPT code 90845 is designated for billing individual psychotherapy sessions where the clinical activities align with the code's definition. It is essential to ensure that documentation supports the billed services to avoid claims denials.

Q2: Is it permissible to bill this code for telehealth sessions?

A: Yes, many payers allow billing for telehealth services using CPT code 90845, provided that the service is synchronous and that appropriate modifiers and patient consent are documented. Always verify specific payer policies regarding telehealth coverage.

Q3: What type of documentation do payers typically request?

A: Payers commonly request documentation that includes the time spent during the session, the therapeutic techniques or assessment instruments utilized, the patient's responses, and a clear connection to a covered ICD-10 diagnosis.

Q4: Can CPT code 90845 be billed in conjunction with other services?

A: Yes, when billing for multiple services, it is crucial to document distinct times and the rationale for each service provided. Utilize add-on codes or adhere to Evaluation and Management (E/M) separation rules as applicable to ensure accurate billing.

Q5: What are some common reasons for claims denials related to this code?

A: Common denial reasons include missing or incomplete time records, insufficient documentation of medical necessity, incorrect use of modifiers, or billing beyond established frequency limits.