90847 – Psychotherapy Service
CPT code 90847 represents a distinct mental or behavioral health service, including evaluation, therapy, or care coordination.
What is CPT
90847
?
90847 is a specific CPT code utilized for billing family psychotherapy sessions that involve both the patient and their family members. This entry provides an in-depth overview of the clinical intent behind this code, the necessary documentation standards, and payer-specific considerations that healthcare providers must adhere to. It is crucial for practitioners to ensure that clinical notes align with evidence-based practices, clearly outlining treatment objectives, the interventions employed during sessions, and measurable outcomes. For time-based billing, accurate recording of start and stop times is essential to substantiate the billed duration.
Documentation Tips
When billing for 90847, it is imperative to document the start and end times of each session, especially when billing is time-based. Include detailed descriptions of the therapeutic modality employed, such as Cognitive Behavioral Therapy (CBT) or Dialectical Behavior Therapy (DBT), as well as the specific assessment tools used during the session. Record the clinical focus of the session, the patient's response to interventions, and outline a clear follow-up plan. For any scoring instruments used, retain copies of completed tools as part of the patient's record. In the case of telehealth sessions, document the patient's consent to participate via telecommunication methods and provide details regarding the platform used. Ensure that documentation adheres to standardized formats such as SOAP (Subjective, Objective, Assessment, Plan) or DAP (Data, Assessment, Plan) to facilitate audit readiness and compliance.
At a Glance
- Service Type: Family Psychotherapy
- Use Case: Sessions involving individuals and their families
- Typical Setting: Outpatient clinics, telehealth platforms (subject to payer policies)
- Billing Unit: Per session, based on the complexity of the service
- Common Pairings: 90791, 90846, and other psychotherapy codes
Billing Examples
A clinician conducts a family therapy session aimed at improving communication among family members dealing with anxiety-related issues. During the session, the clinician applies the principles of CBT to address specific behavioral patterns, documenting interventions such as role-playing and communication exercises. The clinician notes measurable progress by detailing changes in family dynamics and individual responses to therapy. It is important to bill using the appropriate time-based psychotherapy code that accurately reflects the actual duration of face-to-face interaction, ensuring that shorter or extended sessions are billed correctly.
Compliance Guidelines
- Prior to billing, verify payer coverage and authorization requirements to ensure compliance with insurance policies.
- Document medical necessity diligently, linking each service provided to a relevant ICD-10 diagnosis to justify the treatment.
- Utilize the correct modifiers, such as modifier 95 for telehealth services, as required by different payers.
- Avoid upcoding; select the code that accurately reflects the documented time and level of service provided to maintain compliance.
- Conduct regular audits of billing practices to minimize claims denials and enhance the quality of documentation, ensuring adherence to payer requirements.
Common ICD-10 Codes
Helpful links for mental health billing and documentation
- F32.0
- F41.1
- F33.1
- F43.10
- F41.9
- F34.1
Additional Resources
Helpful links for mental health billing and documentation
Related CPT Codes
Helpful links for mental health billing and documentation
Got questions? We’ve got answers.
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Q1: What is the clinical purpose of CPT code 90847?
A: CPT code 90847 is specifically designated for family psychotherapy sessions that include both the patient and family members. It ensures that the therapeutic approach addresses the dynamics of family interactions alongside individual treatment.
Q2: Is it possible to bill for this service via telehealth?
A: Yes, many insurance payers allow billing for telehealth services provided that the session is synchronous, and proper documentation of consent and the platform used is recorded in the patient’s file. Always check specific payer policies for telehealth coverage.
Q3: What kind of documentation may payers request for this code?
A: Payers typically request detailed documentation that includes the duration of the session, therapeutic techniques or assessment instruments utilized, patient and family responses, and a clear linkage to applicable ICD-10 diagnoses.
Q4: Can CPT code 90847 be billed in conjunction with other services?
A: When billing multiple services, it is vital to document distinct time allocations and the rationale for each service provided. Use add-on codes or follow Evaluation and Management (E/M) separation rules as necessary.
Q5: What are some common reasons for claim denials associated with this code?
A: Common denial reasons include incomplete time records, insufficient documentation of medical necessity, incorrect application of modifiers, or billing beyond the frequency limits established by the payer.
