CPT Coding Changes for Psychiatrists

 Posted Wednesday, May 16, 2012 [This page has been archived. The latest information is available on CPT Changes 2013]

There will be significant changes for coding and billing of psychiatric services beginning on January 1, 2013. A comprehensive review of the codes in the Psychiatry section of CPT by the AMA CPT Editorial Panel has resulted in the creation of new codes and the revision of some existing codes to more accurately reflect the way psychiatry is practiced today. The APA actively participated in the shaping and development of the new codes and coding schema that will describe the work of psychiatrists, advanced practice nurses, psychologists, and social workers.

This new coding framework is the result of the work of an AMA-convened workgroup that included representatives from the AMA CPT panel, the APA, the American Academy of Child and Adolescent Psychiatry, the American Nurses Association, the American Psychiatric Nurses Association, the American Psychological Association, and the National Association of Social Workers.

The AMA has released only general information about the code changes and those who participated in the code review process are bound by a confidentiality agreement not to reveal additional details about the new coding schema until the 2013 CPT book is published by the AMA, which we anticipate will be in September or October.  As soon as we are permitted to share the information we will post it on the APA website.  

Although the changes have been accepted by the CPT Editorial Panel and recommended values for the new codes have been made to CMS by the AMA’s Resource Based Relative Value Update Committee (the RUC), the Centers for Medicare and Medicaid Services (CMS) has the ultimate say in accepting or modifying the RUC’s recommendations before valuation of the new codes is final in November.

As you’ll note on the AMA chart, code 90862 (Pharmacologic Management) has been eliminated.  We would like to remind you that even today the work currently described by 90862 can also be captured using the general evaluation and management codes (99xxx series) used by most physicians.  If you are not familiar with E/M coding and documentation, the APA has an online course, Evaluation and Management Coding (CPT) and Documentation for Psychiatrists, you can access at www.apaeducation.org.  Over the next six months we will be offering a variety of educational opportunities for members on E/M coding to prepare them for the 2013 changes.

The APA is undertaking outreach to commercial payers to ensure that they are aware of the coming changes and will be prepared to reimburse appropriately under the new codes.