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Significant changes in 2013 to CPT® codes for behavioral health services

November 30, 2012

Effective January 1, 2013, significant changes will be made to CPT codes for psychiatry and psychotherapy services. The American Medical Association makes changes to CPT code sets on an annual basis, but the upcoming changes for psychiatry and psychotherapy services will have a more significant impact than usual. The following list includes the changes for several commonly used psychiatry and psychotherapy CPT codes: removal of evaluation and management (E&M) plus psychotherapy codes from the psychiatry section (90805, 90807); deletion of pharmacologic management code 90862 (providers should use appropriate E&M code); distinction between psychotherapy and E&M services (i.e., time spent on E&M services is not counted towards psychotherapeutic services, and separate codes can be used in combination with one another); inclusion of psychiatry add-on codes, which are services performed in addition to a primary service or procedure and never as a stand-alone service; addition of code 90785 for interactive complexity; new code for psychotherapy for a patient in crisis. For more detailed information about these upcoming changes, please refer to the American Psychiatric Association (APA) website. This website includes documents and guides to help you navigate the extensive changes. The APA also encourages behavioral health providers to purchase the 2013 edition of the CPT manual. If you have any questions, please contact Magellan Behavioral Health, Inc. at 1-800-866-4108.

Magellan Behavioral Health, Inc., an independent company, manages mental health and substance abuse benefits for most IBC members.

CPT copyright 2010 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. The AMA assumes no liability for data contained or not contained herein.


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