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E and M and Psychotherapy Coding Algorithm

The document provides guidance on coding evaluation and management (E/M) services alone, E/M services provided with psychotherapy, and psychotherapy services alone. It includes tables that outline the steps and codes to use for different combinations of E/M and psychotherapy services. CPT codes, descriptions, and other data are copyrighted and owned by the American Medical Association, and CPT is a registered trademark of the AMA.

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Rashiden Madjales
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© © All Rights Reserved
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Download as PDF, TXT or read online on Scribd
76 views

E and M and Psychotherapy Coding Algorithm

The document provides guidance on coding evaluation and management (E/M) services alone, E/M services provided with psychotherapy, and psychotherapy services alone. It includes tables that outline the steps and codes to use for different combinations of E/M and psychotherapy services. CPT codes, descriptions, and other data are copyrighted and owned by the American Medical Association, and CPT is a registered trademark of the AMA.

Uploaded by

Rashiden Madjales
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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CPT® five-digit codes, descriptions, and other data only are

copyright 2012 by the American Medical Association (AMA). All

E/M and Psychotherapy Coding Algorithm Rights Reserved. No fee schedules, basic units, relative values or
related listings are included in CPT®. CPT® is a registered
trademark of the American Medical Association (AMA).

E/M Psychotherapy

E/M Alone E/M Plus Psychotherapy Psychotherapy Alone

E/M Code Step 1: Select Family Group Psychotherapy


Examples Psychoanalysis Psychotherapy
E/M Code Therapy Therapy for Crisis
99204
Outpatient

99205
99213
99214
99215 Report Psychotherapy
Type Report
Step 2: Select Report Time
99222
Psychotherapy Pt not present 90846 30-74 min 90839
Inpatient

99223 90845
Time Pt present 90847
PHP

99231 +30 min 90840


Group 90849
99232
99233

Psychotherapy Psychotherapy
Report Report
Report Time Time Report
30 (16-37*) min E/M Code and 90833 30 (16-37*) min 90832
E/M Code 90853
45 (38-52*) min E/M Code and 90836 45 (38-52*) min 90834
60 (53+*) min E/M Code and 90838 60 (53+*) min 90837

Interactive Complexity Present

Psychotherapy Psychotherapy Report


Report Report
Time Time
30 (16-37*) min E/M Code, 90833 and 90785 30 (16-37*) min 90832 and 90785 90853
45 (38-52*) min E/M Code, 90836 and 90785 45 (38-52*) min 90834 and 90785 and  Per CPT Time
60 (53+*) min E/M Code, 90838 and 90785 60 (53+*) min 90837 and 90785 90785 Rule

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