Explaining 90837 CPT Code
What will I learn in this article?
Learn about 90837 CPT Code regarding a 60-minute Pyschotherapy with a patient. We'll go over descriptions, modifiers, places of services, and even a discussion of CMS related pricing for both the provider and payers. Enjoy!
Formal and Layperson Definitions of CPT Code 90837
We're providing both the AMA description above as well as the layperson description so that medical coders, claims analysts, whether you are new to the field or a 20-year veteran, you can quickly find the description of 90837 CPT Code.
AMA Definition of 90837 CPT Code
Psychotherapy, 60 minutes with patient. Not to be confused with 90838 which include the E/M classification.
How to Explain 90837 CPT Code to a New Medical Coder
When you're looking to explain 90837 to your team members, the simpler the better, just state it is Psychotherapy with a patient for a 60-minute consult.
Current CMS Status of CPT Code 90837
These codes are paid separately under the physician fee schedule, if covered. There will be RVUs for codes with this status. The presence of an "A" indicator does not mean that Medicare has made a national coverage determination regarding the service; carriers remain responsible for coverage decisions in the absence of a national Medicare policy.
90837 CPT Code General Information
90837 CPT Code has a diagnostic family of 99, with no age range, with Cosmetic classification of "F", and an MUE Count of “2”, and HOS MUE Count of “3." Based on your contracting you may allow Duplicates with specific reasoning.
When billing or paying CPT Code 90837 we look at the payout percentage against CMS guidelines and your state and territory. By using California as an example and the picture below, you can see the Non-facility RVU is $155.55 and facility rate of $134.81. Taking this into consideration we can adjust a rate at 120% to Medicare to help us both as provider and payers to establish a rate of providing this 60-minute Pyschotherapy consult that is financial viable and profitable to the providers. This process is simple when using our Virtual AuthTech and iVECoder solutions.
90837 CPT Code has a status indicator of Q3 with a payment weight of 1.73850 and payment indicator of 3. If we continue with California, the following numbers would populate within our software as seen below.
82310 CPT Places of Service
There are 51 possible places of service that 90837 CPT Code. By using an AI coding software you can select your place of service, run a mock adjudication and ensure your claim could be paid (provider view), or prior to payment (payer side), and both parties ensure ultimate compliance.
Modifiers for CPT Code 90837
There are currently 83 possible modifiers that could be considered when billing or considering payment for CPT Code 90837. Some of the most commonly used are:
- HO: For masters level
- HP: For psychologist or doctorate level
- U6: Required modifier
- UA: Required modifier
- UB: Required modifier
- UC: Required modifier
- when using modifier 95fir telehealth make sure that the patient's plan accepts this code, or if you are the plan check your coverage and eligibility for this type of service and the requirements that ensue.
Cmmon APC And CCI Bundles with 90837 CPT Code
CPT Code 90837 has a group of 05823 and is a Level 3 Health and Behavior Services, which means its eligible for over 275 bundled codes but there's only a handful of codes that truly apply based on the places of service and the provider included in the bill.
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