Get Telehealth Psychiatric Services CPT Coding updates for Psychiatry, Psychological and Neuropsychological billing. Telehealth is on rise due to COVID-19 pandemic. People are avoiding travelin and expercicing social distancing. This lead CMS to cover more than 80 additional services.

Geographic and originating site Medicare telehealth reimbursement restrictions are waived for mental health services, during emergency periods, under the 2020 CARES Act. To manage the public health emergency (PHE), new Telehealth Psychiatric CPT Codes were added. However, there are some policies that vary state to state.

Cloud EMR & Medical billing companies have experience and technology to simplify processes, add new rules, and enable physicians to focus on patient care without bothering about new challenges and opportunities in evolviling feild of medical billing. But medical billers need to contiously update themselves to serve the providers best and report their telehealth services documented in the new codes to meet state and payer guidelines. That;s why we are proivding these updates on Telehealth Psychiatric Services:

Telehealth Psychiatric Services CPT Coding and Billing

Video-based telepsychiatry allows patients to benefit from convenient, affordable and readily-accessible mental health services. Services that can be billed when provided via telehealth are: Psychological and neuropsychological testing, group psychotherapy, developmental screening, and adaptive behavior assessment and treatment.

Providers of telemental health services should ensure that care delivered telemedicine meet the same standards as in-person care. Telemental health services require appropriate documentation and coding specifying when they are provided.

Psychiatric Telehealth CPT Codes

The CPT codes to report psychiatric services provided via telemedicine with modifier 95 appended are:
  • 90785 Psychiatric interactive complexity
  • 90791, 90792 Psychiatric diagnostic services
  • 90832, 90833, 90834, 90836, 90837, 90838 Psychotherapy services
  • 90839, 90840 Crisis services
  • 90845 Psychoanalysis
  • 90846, 90847 Family therapy services
  • 96116 Neurobehavioral status examination
  • 99201-99205 Outpatient new patient visit
  • 99211-99215 Office outpatient E/M visit
  • 99231-99233 Subsequent hospital care
  • 99354-55 Prolonged service outpatient visit
  • 99356-57 Prolonged service inpatient

Medicare Telehealth Billing

Telehealth services are reimbursed at the same rate as in-person visits. Mental and behavioral health services that can be provided via telehealth are grouped in three categories (www.apaservices.org):

CPT Codes Allowed via Phone Only and Traditional Telehealth
  • Diagnostic Interview (90791, 90792)
  • Psychotherapy (90832, 90833, 90834, 90836, 90837, 90838)
  • Psychoanalysis (90845)
  • Group Psychotherapy (90853)
  • Family Psychotherapy (90846, 90847)
  • Crisis Intervention and Interactive Complexity (90839, 90840, 90785)
  • Neurobehavioral Status Exam (96116, 96121)
  • Psychological Evaluation (96130, 96131)
  • Neuropsychological Evaluation (96132, 96133)
  • Psychological & Neuropsychological Test Administration and Scoring ( 96136, 96137, 96138, 96139)
  • Health Behavior Assessment (96156)
  • Health Behavior Intervention, Individual (96158, 96159)
  • Health Behavior Intervention, Group (96164, 96165)
  • Health Behavior Intervention, Family with patient (96167, 96178)
  • Behavioral Screening (96127)
  • Screening, Brief Intervention, and Referral to Treatment (G0396, G0397)
Traditional Telehealth CPT Codesy For traditional telehealth, telephones may be used only with audio and video functions that provide two-way real-time interactive communication:
  • Developmental Screening and Testing (96110, 96112, 96113)
  • Adaptive Behavior Assessment (97151, 97152, 0362T)
  • Adaptive Behavior Treatment (97153, 97154, 97155, 97156, 97157, 97158, 0373T)
CPT Codes Added to Telehealth List as Non-Covered Services (not reimbursable in Medicare)
  • Psychophysiological therapy (90875)
  • Health Behavior Intervention, Family without patient (96170, 96171)

Telehealth Psychological and Neuropsychological Testing Coding

CMS telehealth codes for Psychological and Neuropsychological Testing, which are temporary additions for the PHE for the COVID-19 pandemic are as follows:
  • 96130 psychological testing evaluation services by physician or other healthcare professional, one hour
  • 96131 psychological testing evaluation services by physician or other healthcare professional, each additional hour
  • 96132 neuropsychological testing evaluation services by physician or other qualified healthcare professional, one hour
  • 96133 neuropsychological testing evaluation services by physician or other qualified healthcare professional, each additional hour
  • 96136 psychological and neurological testing phy/qhp 1s
  • 96137 psychological and neurological testing phy/qhp emotional assessment
  • 96138 psychological and neurological tech phy/qhp emotional assessment
  • 96139 psychological and neurological testing tech emotional assessment

Psychiatry Telemedicine Services Notes

  • Telehealth services can now be provided to both new and established Medicare patients.
  • Psychologists may provide telehealth services from their home.
  • Medicare patients can now receive telehealth services in their own homes as well as in any health-care facility.
  • When using live videoconferencing to facilitate a patient encounter, the same CPT codes should be used as for an in-person visit, but with the Place of Service (POS) appropriate for the specific encounter.
  • For the duration of this emergency declaration, HHS has waived HIPAA penalties for using non-HIPAA compliant video conferencing software and allows conduct telehealth sessions via video platforms such as Skype (basic) and FaceTime.
  • CMS allows for patient-initiated "brief check-ins" via telephone, of duration 5 – 10 minutes.
  • On April 30, 2020 (retroactive to March 1, 2020), CMS started permitting audio only telephone care for the following psychiatry codes: 90785, 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90839, 90840, 90845, 90846, 90847, 90853.
  • CMS has also increased reimbursement for audio-only telephone visits, CPT 99441-3 (rules may vary by locality and specific payers).
  • Psychologists can bill for assessment and management services using codes 98966-68.
  • Visits to patients in nursing homes may be conducted via telehealth.
  • Visits to inpatients and skilled nursing facility residents can be provided not just once every 30 days, but as needed.
  • Cost-sharing for telehealth visits may be reduced or waive during this emergency period. This does not apply to brief communication e-Visits.
The Medicare and commercial payers have updated their policies to include telehealth visits through the period of public health emergency during COVID-19 pandemic. The Telehealth trend is will continue from 2020 to 2021, 2022 and most likely as a permenent provision.
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