2013 CPT Code Changes
New CPT Codes
As of January 1, 2013 new CPT codes must be used in order to be reimbursed from third-party payers. The claims will be denied if you use the old codes. Following is a partial listing of CPT Code changes most relevant to social work practice. Under HIPAA, all insurers are required to use the latest CPT codes. To purchase a copy of the 2013 CPT manual call the AMA at 800 621-8335 or go to https://catalog.ama-assn.org/Catalog/home.jsp for a complete listing of all CPT Codes and any changes.
For dates of service prior to January 1st, use the old codes.
If your session isn’t exactly 30, 45 or 60 minutes, choose the code closest to the actual session length (e.g. 90832 for 16-37 minutes, 90834 for 38-52 minutes, and 90837 for 53 minutes and beyond.) The 90808 code for sessions lasting 75-80 minutes is being deleted.
Contact the insurance companies with whom you are contracted in order to obtain their new fee schedules.
Description Former Code New Code
|Diagnostic Evaluation, no medical services||
|Psychotherapy, 30 min. with client or family member||
Outpatient – 90804
Inpatient – 90816
|Psychotherapy, 45 min. with client or family member||
Outpatient – 90806
Inpatient – 90818
|Psychotherapy, 60 min. with client or family member||
Outpatient – 90808
(formerly 75-80 Minutes)
|Family or conjoint psychotherapy with the client present||
|90847 – no change|
|Family psychotherapy without the client present||
|90846 – no change|
|Group psychotherapy, other than multiple-family group||
|90853 – no change|
|Multiple-family group psychotherapy||
|90849 – no change|
|90845 – no change|
|Psychotherapy for Crisis, first 60 minutes||90839|
|Add-on for each additional 30 minutes for psychotherapy for crisis, used in conjunction with code 90839||+90840|
|Interactive Complexity Add-on CodeAdd-on code to be used in conjunction with codes for primary service; psychiatric diagnostic evaluation(90791);Psychotherapy (90832, 90834, 90837); and group psychotherapy (90853).||+90785Used when there is need to involve people other than the client. This is expected to be used mostly with children.|