2013 CPT Code Changes

Nov 19, 2012 by

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

90801

90791

Psychotherapy, 30 min. with client or family member

Outpatient – 90804

Inpatient – 90816

90832

Psychotherapy, 45 min. with client or family member

Outpatient – 90806

Inpatient – 90818

90834

Psychotherapy, 60 min. with client or family member

Outpatient – 90808

(formerly 75-80 Minutes)

90837

Family or conjoint psychotherapy with the client present

90847

90847 – no change
Family psychotherapy without the client present

90846

90846 – no change
Group psychotherapy, other than multiple-family group

90853

90853 – no change
Multiple-family group psychotherapy

90849

90849 – no change
Psychoanalysis

90845

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.

 

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