Major Changes to Psychiatric CPT Codes to Take Effect Jan. 1

by Rebecca Farley on August 1, 2012

The American Medical Association has announced that there will be significant changes for the coding and billing of almost all psychiatric services beginning on January 1, 2013. These changes will require significant modifications to behavioral health agencies’ workflow and billing processes and practice management systems.

The summary below is from a chart published by the AMA.  Most significantly, code 90862 (Pharmacologic Management) has been eliminated, probably with the expectation that psychiatrists will use general evaluation and management codes (99xxx series).  These codes are used by most physicians, but have not generally been used in behavioral health settings.

In addition, AMA accepted the following coding changes:

  • Establishment of code for pharmacologic management with concurrent deletion of code 90862;
  • Revision of Psychiatry guidelines;
  • Addition of code 908XE for interactive complexity;
  • Deletion of codes 90804-90809, 90810-90815, 90816-90822, 90823-90829, 90857;
  • Addition of codes 908P10, 908P10X, 908P20, 908P20X, 908P30, 908P30X, 908CP2, 908CP2 for psychotherapy; and
  • Revision of codes 90875, 90876

To date, the American Medical Association (AMA) has released only general information about the code changes.  According to the AMA, additional details about the new coding schema will be available on or about August 31, 2012. The National Council is working with the American Psychiatric Association to develop training and technical assistance webinars once all of the changes are known.

The National Council also advises behavioral health agencies to develop a an action plan to:

  • Update charge forms and masters
  • Ensure that electronic systems are updated
  • Provide training and technical assistance to clinical and business office staff
  • Establish communication with payers regarding changes.

The American Psychiatric Association is attempting to notify payers of these impending changes. However, given that psychiatry has not generally used evaluation and management codes, it is possible that there will be some confusion and rejection of claims, or other adverse action initially. Stay tuned to MentalHealthcareReform.org and email communications from the National Council for additional details as they become available.

 

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{ 2 comments… read them below or add one }

Ann Endress MSW LCSW August 2, 2012 at 1:13 pm

The CPT code change as of 2013, will it effect how much Insurance will pay? Mental Health CPT codes 90806 and 90808 will they be elimiated all together focing the mental health profession (Social Workers) to use the new code in place of the above mentioned therefore paying less money?

Ann Endrwess MSW LCSW
aendress@aol.com

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Robert Reed October 23, 2012 at 9:58 am

No one yet knows what the reimbursement will be – CMS will likely publish new codes and RVU’s in the Federal register on 11/02/12 at which time Medicare and other insurers can use the RVU factors to determine their reimbursement models. for the counselling codes -time spans are shrinking, and many beleive the thinking is any visit more than 60 minutes might better be defined as a crisis visit and thus coded as 90839 1st hour and 90840 for each additional 30 minutes. Stay tuned is the best answer anyone can give at this time. My comments are based on avialable research, yours may differ. Best wishes!

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