Overview
Cognitive behavioral therapy has no separate CPT code. CBT is billed using standard individual psychotherapy codes: 90832 (16-37 min), 90834 (38-52 min), or 90837 (53+ min). Group CBT uses CPT 90853. Payers do not differentiate CBT from other therapy modalities for reimbursement purposes. Time-based billing applies to all CBT codes. Reimbursement is identical to non-CBT therapy with same codes and durations.
Coding Rules
Select CPT code based solely on session length, not therapy type. Document specific CBT techniques used during the session: behavioral activation, cognitive restructuring, thought records, exposure therapy, behavioral experiments, or problem-solving strategies. Include homework assigned and patient completion status. Document barriers to homework completion and between-session work outcomes. Time documentation must match the CPT code selected. Do not bill multiple therapy modalities on the same date as separate sessions.
Prior Authorization & Limits
Prior authorization requirements are identical to standard psychotherapy. Most commercial payers require authorization after initial sessions. Session limits apply per payer policy (typically 20-30 sessions annually). Medicare covers medically necessary CBT without session limits. Some payers have higher limits for specific diagnoses (PTSD, anxiety disorders, depression). Verify payer-specific CBT coverage when obtaining authorization.
Bundling & Modifier Rules
Use modifier 25 if billing an E/M service (99213-99215) on the same date as CBT. Modifier 95 indicates telehealth. Modifier 93 indicates audio-only delivery where allowed. Do not bill psychiatric evaluation codes (90791, 90792) on the same date without modifier 25 on the E/M component. Therapy codes do not require additional modifiers for separate procedure identification.
Documentation Requirements
Document exact session times. Specify CBT techniques used: behavioral activation, cognitive restructuring, thought records, exposure, behavioral experiments, or problem-solving. Record homework assigned, completion status, and patient-reported outcomes. Note progress toward specific treatment goals. Include patient barriers to treatment and modifications made to therapy approach.
Common Questions
Is there a separate CPT code for CBT?
No. CBT is billed using standard psychotherapy codes: 90832, 90834, or 90837. Payers do not differentiate CBT from other therapy modalities for reimbursement.
How do I document CBT-specific techniques?
Document specific techniques used (behavioral activation, cognitive restructuring, thought records), homework assigned, patient completion of assignments, and progress toward treatment goals.
What code should I use for group CBT?
Group CBT uses CPT 90853 (group therapy per session). Typically billed for 60-90 minute sessions. Most payers reimburse at 50% or less of individual therapy rates.
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