Psychiatric Codes

This LCD covers psychiatric diagnostic evaluations, psychological and neuropsychological testing, psychotherapy (individual, group, family), and other psychiatric procedures (narcosynthesis, ECT) when medical necessity is documented and services are within the provider’s state-authorized scope of practice. Testing and psychotherapy are covered only when clinically indicated (not routine screening), each test/component is individually justified and documented, patients have sufficient cognitive capacity to participate when required, and specific limits apply (eg, group size 10, session 45–60 minutes, aphasia testing typically once). Providers must document medical necessity, licensure/authorization, and follow CMS/IOM guidance and any referenced LCDs or utilization guidelines.

"Diagnostic psychiatric interview is indicated for initial or periodic diagnostic evaluation of a patient with suspected or diagnosed psychiatric illness."