Billing and Coding: Psychiatry and Psychology Services

This policy details appropriate use and billing of psychiatric and psychology CPT/HCPCS codes, including diagnostic evaluations (90791/90792), psychotherapy (90832-90838), family (90846/90847) and group therapy (90853), crisis psychotherapy (90839/90840), and interactive complexity add-on (90785). Coverage permits initial diagnostic evaluations once at onset with limited repeat circumstances (e.g., ~6-month break, inpatient admission, marked mental status change), requires documentation for combined E/M and psychotherapy to be separately identifiable, and disallows certain uses (e.g., add-ons billed alone, biofeedback for psychosomatic disorders, incidental codes 90885/90887/90889 not separately payable).

"A psychiatric diagnostic evaluation (CPT 90791) or with medical services (CPT 90792) may be performed once at the onset of an illness or suspected illness."