Are you submitting claims for any of the following CPT codes?
Psychotherapy codes and session times
- 90382: 30 minutes
- 90834: 45 minutes
- 90837: 60+ minutes
Evaluation and Management (E/M) service codes and session times
New Outpatients
- 99202: 15-29 minutes
- 99203: 30-44 minutes
- 99204: 45-59 minutes
- 99205: 60-74 minutes
Established Outpatients
- 99211: Time component removed
- 99212: 10-19 minutes
- 99213: 20-29 minutes
- 99214: 30-39 minutes
- 99215: 40-54 minutes
Psychotherapy add on codes and session times
- 90833: 16-37 minutes
- 90836: 38-52 minutes
- 90838: 53+ minutes
Checking the three most common errors when submitting medical records for Psychotherapy, Evaluation and Management (E/M) and psychotherapy add-on services may help prevent claim denial and ensure prompt payment.
3 things to include in your session documentation
- Is information missing or incorrect? Verify you included signature, credentials and start/stop times. Check that the session time matches the code requirements. If the patient’s family was present and part of the therapy session, consider a family therapy code.
- Did you meet the Medical Decision Making (MDM) requirements for the E/M code billed? Did you bill at a higher level, but only meet the requirements for the lower level? It’s common to bill at a higher E/M based on time.
- Are the services listed separately? Please ensure psychotherapy is documented distinctly from the E/M service, and that you document the entire session (psychotherapy + E/M therapy).
Additional resources
Please consult the following resources for additional guidance on submitting E/M and psychotherapy-related medical records: