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.
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 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.
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.
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.
No. CBT is billed using standard psychotherapy codes: 90832, 90834, or 90837. Payers do not differentiate CBT from other therapy modalities for reimbursement.
Document specific techniques used (behavioral activation, cognitive restructuring, thought records), homework assigned, patient completion of assignments, and progress toward treatment goals.
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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