Service Codes
Service codes are defined for insurance and other purposes to indicate which service the clinician performed. Specific requirements are needed to bill these service codes, such as the length (time) of the appointment.
Intake Service Codes (Therapy)
[DEFAULT] 90791: Individual - Therapy Intake (16+ mins)
- Duration: 16+ minutes
- Units: 1 unit max
- Notes: Most intakes last 50+ minutes. Any 90791 code can be billed to insurance only once every 365 days.
90791: Individual - Therapy Intake (16+ mins) AUDIO ONLY
- Duration: 16+ minutes can be billed for each additional 30 minutes of crisis psychotherapy 40 can be billed for each additional 30 minutes of crisis psychotherapy
- Units: 1 unit max
- Notes: Last resort service code. Only to be used if telehealth technology fails. Any 90791 code can be billed to insurance only once every 365 days.
90791: Couples/Family - Therapy Intake (16+ mins)
- Duration: 16+ minutes
- Units: Bill for 1 unit for every 60 minutes spent on this service during a single session
- Notes: Any 90791 code can be billed to insurance only once every 365 days.
90791: Couples/Family - Therapy Intake (16+ mins)
- Duration: 16+ minutes
- Units: Bill for 1 unit for every 60 minutes spent on this service during a single session
- Notes: Any 90791 code can be billed to insurance only once every 365 days.
90834: EAP UHC - Therapy Intake (45 mins)
- Duration: 45+ minutes
- Units: 1 unit max
- Notes: Must be used for EAP intakes with UnitedHealthcare (UHC)
99404: EAP Cigna - Therapy Intake (45+ mins)
- Duration: 45+ minutes
- Units: 1 unit max
- Notes: Must be used for EAP intakes with Cigna.
90839: Crisis - Therapy Intake (60+ mins)
- Duration: 60+ minutes
- Units: 1 unit max
- Notes: Intake appointment, client is in crisis. Psychotherapy for crisis; first 60 minutes. Billed for the first 60 mins of psychotherapy for a patient in crisis, and add-on code 90840 billed for each additional 30 mins. CPT code 90839 is the principal code for a crisis psychotherapy session that requires urgent assessment, history of the crisis state, mental status exam, and disposition. It is billed for the first 60 minutes of psychotherapy for a patient in crisis. If/when the crisis psychotherapy session lasts longer than 60 minutes, the add-on code, 90840, can be billed for each additional 30 minutes of psychotherapy for the crisis. For the new crisis codes to apply, the presenting problem must typically be life-threatening or complex and require immediate attention to a patient in high distress. Medicaid does not cover 90839 via Telehealth. Best practices state that clients in crisis should be seen in person.
PROBONO: FREE Therapy Intake
- Duration: NA
- Units: 1 unit max
- Notes: This will create a free intake appointment for the client and clinician. Learn more: Pro Bono Policy.
Intake Addon Codes (Therapy)
You'll be able to learn more about how to add an addon code here.
+90785: Interactive complexity add-on code
- Duration: NA
- Units: 1 unit max
- Notes: This will create a free intake appointment for the client and clinician. Learn more: Pro Bono Policy
+90840: Crisis Additional 30+ minutes (only use with 90839)
- Duration: NA
- Units: Bill for 1 unit for every 30 minutes spent on this service during a single session
- Notes: Psychotherapy for crisis; each additional 30 minutes (List separately in addition to code for primary service
Session Service Codes (Therapy)
[DEFAULT] 90837: Individual - Therapy Session (53+ mins)
- Duration: 53+ minutes
- Units: Bill for 1 unit for every 60 minutes spent on this service during a single session; however, insurance only allows 1 unit per 24-hour period.
- Notes: Typical psychotherapy.
90837: Individual - Therapy Session (38-52 mins) AUDIO ONLY
- Duration: 38-52 minutes
- Units: 1 unit max
- Notes: Only to be used if necessary (video technology fails).
90834: Individual - Therapy Session (38-52 mins)
- Duration: 38-52 minutes
- Units: 1 unit max
- Notes: Typical psychotherapy.
90834: Individual - Therapy Session (38-52 mins) AUDIO ONLY
- Duration: 38-52 minutes
- Units: 1 unit max
- Notes: Only to be used if necessary (video technology fails).
90834: EAP UHC - Therapy Session (45 mins)
- Duration: 45 minutes
- Units: 1 unit max
- Notes: Must be used for EAP sessions from UnitedHealthcare (UHC).
90834: EMDR Therapy (74+ mins)
- Duration: 74+ minutes
- Units: 1 unit max
- Notes: Typically used for EMDR or similar
90832: Individual - Therapy Session (16-37 mins)
- Duration: 16-37 minutes
- Units: Bill for 1 unit for every 37 minutes spent on this service during a single session
- Notes: Typical psychotherapy.
90832: Individual - Therapy Session (16-37 mins) AUDIO ONLY
- Duration: 16-37 minutes
- Units: 1 unit max
- Notes: Only to be used if necessary (video technology fails).
90847: Couples/Family - Therapy Session (50+ mins, 1 unit)
- Duration: 50+ minutes
- Units: 1 unit max
- Notes: Ongoing couples/family therapy.
90847: Couples/Family - Therapy Session (multi-unit per 50 mins)
- Duration: 50+ minutes
- Units: Bill for 1 unit for every 50 minutes spent on this service during a single session
- Notes: Only for self-pay clients.
FAQs
If the client only wants to come in for a 30-minute session (not that they were 30 minutes late to their 60-minute appt.) but they truly only like 30 minutes, what code do I use?
- Use service code 90832.
If a client wants to come to back-to-back sessions (2 hours)?
- (2) Units of the self-pay rate would apply. Insurance doesn’t approve (2) 90837s being billed on the same day.
Can you bill Individual and Couples/family sessions on the same day?
- Yes. A client’s insurance can be billed 90837, then billed 90847. The 90847 (patient and others) or 90846 (patient not present) code must have a 59 modifier attached to demonstrate that the service is “separate or unique” from the 90837. Email the Billing Team so they can set up the client’s billing correctly.
Addon Codes
How to add an addon code in TN
Inside the note header, you can add the appropriate addons.
