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 Psychiatric diagnostic evaluation without medical services. This code is used for initial evaluations conducted by psychiatrists, psychologists, or other qualified mental health professionals. It includes a comprehensive assessment of the patient's mental health history, current symptoms, and functional status, as well as the formulation of a diagnosis and initial treatment plan. 

 Psychiatric diagnostic evaluation with medical services. This code is similar to 90791 but includes an evaluation of the patient's medical history and physical health status in addition to the psychiatric assessment. It is often used when the evaluation is conducted by a psychiatrist who is also providing medical management or when medical issues may be contributing to the patient's mental health symptoms. 

  Interactive complexity. This code is used in conjunction with psychiatric diagnostic evaluation codes (90791 or 90792) when the evaluation involves additional complexities that require increased clinical attention. This may include factors such as communication barriers, high emotional intensity, or involvement of multiple parties (e.g., family members, caregivers) in the evaluation process. 

 This code is used for individual psychotherapy, typically lasting 30 minutes. It covers face-to-face sessions between a therapist and a patient, during which therapeutic techniques are employed to address mental health concerns. 

 This code is an add-on code used with primary or other CPT codes  to indicate an additional 30 minutes of psychotherapy provided beyond the typical session duration. It is typically used when therapy sessions exceed the standard 30-minute, 45-minute, or 60-minute durations. 

 Similar to 90832, this code also covers individual psychotherapy sessions. However, it is for sessions lasting 45 minutes, indicating a longer duration of therapy. 

 Similar to 90833, this add-on code indicates an additional 45 minutes of psychotherapy provided beyond the typical session duration. It is used in conjunction with primary or other CPT codes to bill for longer therapy sessions. 

 This code is for individual psychotherapy sessions lasting 60 minutes. It is used when therapy sessions extend beyond the typical 45-minute duration, providing additional time for in-depth exploration and intervention. 

 This code is used for family psychotherapy sessions. It involves psychotherapeutic interventions with multiple family members present, addressing family dynamics, communication patterns, and interpersonal relationships. 

 This code is used for family psychotherapy without the patient present. It covers sessions in which the therapist works with family members but the identified patient is not present, often to address family issues or dynamics that may be impacting the patient's mental health. 

 This code is for group psychotherapy sessions. It involves therapeutic interventions conducted in a group setting with multiple participants, allowing for peer support, feedback, and interpersonal learning 

 This code is used for crisis psychotherapy sessions. It covers psychotherapy services provided during a crisis or emergency situation, typically involving imminent risk of harm to the patient or others. 

As per  Handbook for Providers of Medical Services Chpt 100 - General Policy and Procedure, pg. 47 ,   All required records are to be available for inspection, audit and copying (including photocopying) by authorized Department personnel or designees during normal business hours. Such personnel or  designees may include, but are not limited to, the Department’s Office of Inspector General, representatives of the Medicaid Fraud Control Unit, law enforcement personnel, the Office of the Auditor  General, and the federal Centers for Medicare and Medicaid Services (CMS). 

  The Billing NPI (formerly referred to as Payee NPI) must be reported in loop 2010AA  and   The Rendering Provider NPI must be entered in loop 2310B, Rendering Provider.

  Behavioral Health services must meet specific requirements for reimbursement. Documented services must: 

  • Meet that State’s Medicaid program rules

  • To the extent required under State law, reflect medical necessity and justify the treatment and clinical  rationale

  • To the extent required under State law, reflect active treatment;  

  • Be complete, concise, and accurate, including the face-to-face time spent with the patient 

 • Be legible, signed, and dated; 

 • Be maintained and available for review

 • Be coded correctly for billing purposes. 

  Documentation to support services provided for which reimbursement is claimed shall be in the format specified by the public payer, shall be legible.

Effective with dates of service beginning October 1, 2021, providers billing a service that was performed via audio or video communication must append the procedure code with modifier GT and use  Place of Service Code 02. 

Behavioral health practitioners are in the business of helping their patients. Patients are their priority. Meeting  ongoing patient needs, such as furnishing and coordinating necessary services, is impossible without documenting each patient encounter completely, accurately, and in a timely manner.