Basics of CPT Code 90832, 90833, 90834, 90836, 90837, 90838 

Psychotherapy, or talk therapy, is a way to help people with a broad variety of mental illnesses and emotional difficulties. Psychotherapy can help eliminate or control troubling symptoms so a person can function better and can increase well-being and healing.

In medical coding, we have separate procedure codes for psychotherapy services. The psychotherapy service codes 90832-90838 include ongoing assessment and adjustment of psychotherapeutic interventions, and may include involvement of informants in the treatment process.

CPT Code 90832, 90833, 90834, 90836, 90837, 90838 describe psychotherapy for the individual patient, although times are for face-to-face services with patient and may include informant(s).

Do remember when reporting individual psychotherapy, the patient is required to be present for all or a majority of the service, instead of for only some of the service; thus, time reporting is a factor.

For family psychotherapy services, use CPT code 90846 and 90847.

Codes for individual and family psychotherapy can be coded together. CPT Codes 90832, 90833, 90834, 90836, 90837, and 90838 may be reported on the same day as codes 90846 and 90847, when the services are separate and distinct.

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Code description for Psychotherapy CPT Code 90832, 90833, 90834, 90836, 90837, and 90838

Time is the main criteria for selecting the correct CPT code. Choose the code closest to the actual time, for reporting the actual Psychotherapy service code. A unit of time is attained when the mid-point is passed.

Follow the below pattern for coding right procedure code.

Time                                     CPT code

16-37 minutes                 90832-90833

38-52 minutes                90834-90836

53 or more minutes     90837-90838

26 or more minutes     90846-90847

Less than 16 minutes for duration for individual psychotherapy service is not reported.

For family psychotherapy services lasting less than 26 minutes should not be reported

90832 Psychotherapy, 30 minutes with patient

+90833 Psychotherapy, 30 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure)

90834 Psychotherapy, 45 minutes with patient

+90836 Psychotherapy, 45 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure)

90837 Psychotherapy, 60 minutes with patient  

+90838 Psychotherapy, 60 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure)

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Psychotherapy for Crisis Services (CPT code 90839 and 90840)

90839Psychotherapy for crisis; first 60 minutes

+90840each additional 30 minutes (List separately in addition to code for primary service)

Family Psychotherapy CPT codes 90845, 90846, 90847, 90849 & 90853

For CPT code 90845, the therapist performs psychoanalysis by utilizing methods of intense observation and analytical skills to investigate the patient’s past experiences, unconscious motivations, and internal conflicts, as well as contributing medical conditions, to discover how these pilot the patient’s current behavior and emotions. The psychiatrist seeks to produce change in maladapted behavior.

Psychoanalysis includes reviewing medical notes and making clinical setting arrangements, assisting the patient in further self-awareness, working through barriers, understanding self-observations, and modifying mental behavior and status while continuing to elicit more information and personal exploration. This code also includes follow-up work of documentation, content review, and peer consultation.

90845    Psychoanalysis

For CPT code 90846, the therapist provides 50 minutes of family psychotherapy in a setting where the care provider meets with the patient’s family without the patient present. The family is part of the patient evaluation and treatment process. Family dynamics as they relate to the patient’s mental status and behavior are a main focus of the sessions. Attention is also given to the impact the patient’s condition has on the family, with therapy aimed at improving the interaction between the patient and family members.

90846    Family psychotherapy (without the patient present), 50 minutes

For CPT code 90847, the therapist provides 50 minutes of family psychotherapy in a setting where the care provider meets with the patient and the patient’s family jointly. The family is part of the patient evaluation and treatment process. Family dynamics as they relate to the patient’s mental status and behavior are a main focus of the sessions. Attention is also given to the impact the patient’s condition has on the family, with therapy aimed at improving the interaction between the patient and family members.

Reviewing records, communicating with other providers, observing and interpreting patterns of behavior and communication between the patient and family members, and decision making regarding treatment, including medication management or any physical exam related to the medication, is included.

90847    Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes

For CPT code 90849, Multiple family group psychotherapy provided to a patient and his/her family, as well as other patients and families, altogether. This is usually done in cases involving similar issues and often in settings of group homes, drug treatment facilities, or hospital rehabilitation centers. The session may focus on the issues of the patient’s hospitalization or substance abuse problems. This code is reported once for each family group present.

90849    Multiple-family group psychotherapy

For CPT code 90853, the psychiatric treatment provider conducts psychotherapy for a group of several patients in one session. Group dynamics are explored. Emotional and rational cognitive interactions between individual persons in the group are facilitated and observed. Personal dynamics of any individual patient may be discussed within the group setting.

Processes that help patients move toward emotional healing and modification of thought and behavior are used, such as facilitating improved interpersonal exchanges, group support, and reminiscing. The group may be composed of patients with separate and distinct maladaptive disorders or persons sharing some facet of a disorder. This code should be used for group psychotherapy with other patients, and not members of the patients’ families.

90853    Group psychotherapy (other than of a multiple-family group)

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Do and Don’t with Psychotherapy CPT codes

CPT code 90833, 90836 and 90838 are add-on codes, hence use along with primary CPT codes.

Use CPT code 90833 in conjunction with 99201-99255, 99304-99337, 99341-99350

Use CPT code 90836 in conjunction with 99201-99255, 99304-99337, 99341-99350

Use CPT code 90838 in conjunction with 99201-99255, 99304-99337, 99341-99350

Do not report psychotherapy of less than 16 minutes’ duration.

Use CPT code 90840 in conjunction with 90839

Do not report 90846, 90847 for family psychotherapy services less than 26 minutes

Do not report 90839, 90840 in conjunction with 90832-90838

Psychotherapy services may be reported on the same day as an E/M service