Billing and Coding: Outpatient Psychiatry and Psychology Services

This policy provides billing and coding guidance for outpatient psychiatry and psychology services: provider-type and place-of-service dictate whether services are billed to Part A or Part B MACs, psychotherapy codes must be used when psychotherapy is the primary focus, and CPT 90863 may be billed in addition when pharmacological management occurs during a psychotherapy visit. Claims must include a valid ICD-10-CM diagnosis code, relevant documentation (assessment, history, test results, signed notes) to support medical necessity, and follow NCCI/OPPS edits; activity therapy and patient education are generally not separately payable under OPPS and incident-to psychologist services in hospitals are bundled to the facility.

"Outpatient psychiatry and psychology services are payable under Medicare Part B when provided in accepted places of service listed (e."

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