Top 3 CPT Codes for Mental Health Billing

Get the Maximum Reimbursement for Your Mental Health Services with CPT Codes  

Mental Health Billing

Mental health is an important part of overall well-being, and providing quality care requires that both healthcare providers and billing companies have a clear understanding of the services being provided. That’s why it’s essential to be familiar with the top three CPT codes for mental health billing: 90791, 90837, and 90846.  

 

In this blog, we’ll look at how these codes are used to identify specific mental health procedures, services, and supplies in order to help you get the maximum reimbursement for your mental health services.  

Overview of CPT codes for mental health billing 

Healthcare providers and billing companies use CPT codes for mental health billing to identify and communicate the services that have been provided accurately. These codes provide a standardized way of indicating specific procedures, services, and supplies related to mental health treatment and care, allowing healthcare providers to be reimbursed for their time and effort.  

 

The three most commonly used CPT codes for mental health billing are 90791, 90837, and 90846. Each one is associated with a specific type of mental health care.  

 

90791: This code is the most common of all three and covers an initial evaluation by a clinician, including medical history review, physical exam, and mental status exam. This code is typically used for the initial visit from a new patient who has not yet been diagnosed with a mental disorder.  

 

90837: This code is often used for billing for psychotherapy sessions, including individual, family, and group therapy. It should be noted that this code only applies when the patient is seen for 45 minutes or longer.  

 

90846: This code is used for billing for family psychotherapy when the patient and family member(s) are present during the session. It is also important to note that this code should only be used if the family therapy session lasts at least 50 minutes.  

 How to use the top three CPT codes (90791, 90837, and 90846)

 

Using the top three CPT codes for mental health billing can help ensure that healthcare providers and billing companies are accurately tracking services and getting the maximum reimbursement for their hard work. Here’s how:  

 

1. Identify the correct code: The first step is to make sure you have identified the correct code based on the services provided. 90791 would be used for the initial evaluation of an individual, while 90837 and 90846 are both used for psychotherapy sessions—with 90837 covering individual, family, and group therapy lasting 45 minutes or longer and 90846 covering family therapy that lasts 50 minutes or more.  

 

2. Track services: It’s important to track all services that have been provided in order to get the maximum reimbursement for your time and effort. Accurately filling out the CPT codes will help ensure that nothing is missed.  

 

3. Submit claims: Once you are sure that all relevant CPT codes have been filled out, you can submit your claims to the insurance company or other third-party payer. This will ensure that you get the maximum reimbursement for your mental health services.  

Common mistakes made when using CPT codes for mental health billing 

Using the wrong code: One of the most common mistakes made when using CPT codes for mental health billing is to use the wrong code. For example, submitting a claim with 90837 instead of 90846 when family therapy was provided can result in a lower reimbursement rate.  

 

Forgetting to track services: Failing to track all services that have been provided can result in a lower reimbursement rate as well. It’s important to ensure that all relevant CPT codes are filled out accurately and submitted with the claim.  

 

Not submitting claims promptly: Finally, it’s important to submit claims promptly in order to get the maximum reimbursement for your mental health services. Claims that are submitted late can result in lower reimbursement rates or even a denial of the claim altogether.  

Final Thoughts 

Using CPT codes for mental health billing can help ensure that healthcare providers are accurately tracked and reimbursed for their services. It’s important to make sure you have identified the right code, tracked all services provided, and submitted claims promptly in order to get the maximum reimbursement. Taking the time to double-check your work will save you time and money in the long run.  

 

For more information, get in touch with HMS USA LLC, the best affordable medical billing company in NY, for professional medical billing services. We will provide you with the best solutions for all your mental and physical health billing needs. Contact us today!