Per CPT Knowledge base KB #: 6206 Date: 06/17/2015 "If both Evaluation and Management (E/M) services and Psychotherapy services are significant and separately identifiable, codes 90833 , 90836 , and 90838 , which are specific for psychotherapy when performed with E/M services, may be used as add-on codes to the E/M service." Would this directive apply to Facility coding? ...
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Article Overview
This article reviews a CPT Knowledge Base question about the relationship between evaluation and management services and psychotherapy services when both are provided on the same day. It explains the general CPT perspective, notes that psychiatry services are reported without regard to setting, and highlights that payer or facility policies may differ from CPT guidance. The content is useful for coders, billing staff, and compliance personnel who need to understand how CPT guidance intersects with local facility and third-party payer rules.
Why This Topic Matters
Psychiatry and behavioral health coding often depends on both CPT guidance and local policy requirements. Understanding the distinction between national CPT guidance and facility or payer-specific rules helps reduce reporting errors and compliance risk.
What You Will Learn
- How CPT addresses psychotherapy services reported with evaluation and management services
- Why setting and payer policy may affect reporting decisions
- How CPT guidance can differ from facility compliance requirements
- Who may need to resolve payer or facility-specific questions
Who Should Read This
- Medical coders
- Billing staff
- Facility compliance officers
- Behavioral health practices
- Psychiatry providers
Codes Discussed
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