Maximize Your Revenue Streams: Behavioral Health CPT Codes Cheat Sheet 2022

Make the Most of Your Behavioral Health Services Revenue Streams with CPT Codes Cheat Sheet 2022

If you are a healthcare provider offering behavioral health services, you already know how crucial accurate coding of your services is to obtain optimal reimbursement rates. CPT (Current Procedural Terminology) codes are the standardized system by which healthcare providers describe and bill for their services. However, keeping up with the latest CPT codes and updates can be challenging, causing errors in documentation and billing, leading to denied or reduced claims, and ultimately costing your practice valuable revenue. In this article, we will delve into some essential CPT codes for behavioral health services, along with useful tips and insights to boost your practice revenue in 2022.

The Basics of CPT Coding for Behavioral Health Services

Here are some essential terms that you should be familiar with when coding for behavioral health services:

• CPT codes: A numerical code used to describe medical services or procedures performed by providers
• Diagnostic codes: Alphanumeric codes used to cover diagnoses for services rendered by healthcare providers
• Modifiers: Two-digit codes added to CPT codes to indicate specific circumstances to help define the service provided further
• Place of service codes: Three-digit codes that indicate where the healthcare service was provided
• Relative Value Units (RVUs): Units of measure Healthcare providers use to determine medical service reimbursements with Medicare and commercial payers

Important CPT Codes for Behavioral Health Services

Here are some essential CPT codes for behavioral health professionals:

CPT Code 90791: Psychiatric diagnostic evaluation

CPT 90791 is a comprehensive diagnostic evaluation used to make a diagnosis and treatment plan for a patient with mental illness. It is the most common initial service psychiatrists and other mental health professionals use to assess new patients, and it’s crucial to code it accurately as it sets the tone for the course of treatment and the insurance eligibility. The code is reimbursable by both Medicare and Medicaid, and some other commercial payers, with an average reimbursement rate of $156 and up to a 90-minute maximum length of time.

CPT Code 90834: Psychotherapy, 45 minutes with the patient

CPT 90834 is the code used to describe individual psychotherapy sessions lasting 45-50 minutes regularly. The therapy aims to help the patient alleviate symptoms, understand their behavior, and develop better coping skills to improve their mental health. The reimbursement rate varies by geographical location and insurance coverage. However, the national Medicare reimbursement fee is approximately $95 with patients responsible for cost-sharing expenses.

CPT Code 90837: Psychotherapy, 60 minutes with a patient

CPT 90837 is a common code for extended individual psychotherapy of 60 minutes of patient contact time. Providers use it in situations when therapy may require more time than the standard 45-50-minute treatment. The reimbursement rate for this code also varies by insurance coverage, with the national Medicare fee schedule reimbursement rate set at about $143, with patients responsible for cost-sharing expenses.

Maximizing Your Behavioral Health Services Revenue Streams With CPT Cheat Sheet 2022

Accurate and compliant coding using the latest CPT codes is crucial to maximizing your revenue streams for behavioral health services. However, keeping up to date with new and updated codes is a time-consuming process that requires ongoing effort and resources. Use these tips to help your practice stay on top of CPT coding:

• Train your staff on proper coding techniques and updates to ensure ongoing accuracy
• Use a reliable CPT coding resource to verify and keep up with new and updated codes. The American Medical Association (AMA) publishes the CPT codebook annually and offers updates several times each year
• Stay informed about updates to rules, regulations, and policy changes with Medicare, commercial payers, and other payer sources that may affect your reimbursement rates. Regular communication with payers and billing alerts also help to avoid payment issues
• Use technology to make coding and billing processes more efficient. Electronic Health Records (EHR) and Revenue Cycle Management (RCM) software can help streamline coding and documentation and reduce errors in billing and payments

Conclusion

Accurate CPT coding is essential to maximize revenue from your behavioral health services. In 2022, stay up to date on the latest codes and properly document all patient interactions, making use of the helpful tips provided in this article. Staying compliant with billing and coding rules and regulations can be a complicated task, but by ensuring you and your staff remain informed and using appropriate resources, you can work towards higher service reimbursements accurately.