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Billing and coding

Here’s how to find the CPT codes you need

CPT codes can seem complex at first, but they simplify the process of coding and billing.

Working with clients is an important part of a therapist’s job, but it’s only one aspect of the work you do. To get paid for your work, you’ll also need to bill for the services you provide. Specifically, if you bill insurance, that means you’ll need to understand and use CPT codes on a regular basis. 

CPT codes can seem complex at first, but they ultimately simplify the process of coding and billing for healthcare services, including behavioral health. Below, learn more about how to find CPT codes to make billing and working with insurance easier.

What are CPT codes?

Current Procedural Terminology (CPT) codes are five-digit codes used by healthcare providers to describe medical, diagnostic, and therapeutic services for billing and documentation purposes.

CPT codes provide healthcare professionals with a standardized language for efficiently coding medical and behavioral health services. Along with billing, CPT codes are used for processing claims with insurance payers. 

Filing an insurance claim for psychotherapy requires assigning a CPT code to each session. The code should describe the level of service you provided. 

CPT code categories

Most health care professionals, including therapists, use five-digit CPT codes—or category I codes—which encompass well-established procedures. Category II CPT codes are supplementary codes that involve gathering information about quality of care; they’re not reimbursable. Category III CPT codes involve new technologies and procedures. 

What does a CPT code look like?

CPT codes are typically five-digit numeric codes. Some CPT codes are one letter and four numbers, but those are generally used for non-physician services (for example, providing durable medical equipment, medications, and supplies). 

Which CPT codes you use depends on a few factors, such as if you’re a therapist or prescriber or whether you’re seeing a new or existing client. Some of the most common behavioral health CPT codes include: 

How to find CPT codes

CPT codes were developed by the American Medical Association (AMA). You can look up behavioral health CPT codes on the AMA’s website for free after signing up, or you can order the CPT code manual book. 

Most EHRs have built-in systems for finding CPT codes. As a Headway provider, once you complete a session with a patient, you will begin a progress note. Progress notes are where CPT codes live, and where you will select a CPT code to file your claim.

In Sigmund, when you go to confirm your session details, you can also assign a CPT code. You'll be able to select from a drop-down menu that shows both the CPT code and defines what that covers (i.e. 90834—Psychotherapy, 45 minutes (38-52 minutes)).

If you want to learn more about CPT Coding Standards, check out our Headway Academy course. Prescribing providers can learn more at Headway’s Psychiatrist and Nurse Practitioner Resource Hub.

Headway is a free service that makes it easier and more profitable for therapists and psychiatrists to accept insurance.

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Billing and coding

How to use CPT code 90833

Code 90833 represents an add-on for 16 to 37 minutes of psychotherapy with an E/M code.

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How to use CPT code 90838

Code 90838 represents an add-on for at least 53 minutes of psychotherapy with an E/M code.

How to use CPT code 90838