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Coding and Billing Guidelines - Centers for Medicare ...

1 Coding and Billing Guidelines *Psychiatry and Psychology Services PSYCH-014 - L30489 Contractor Name Wisconsin Physicians Service (WPS) Contractor Number 00951, 00952, 00953, 00954 05101, 05201, 05301, 05401, 05102, 05202, 05302, 05402, 52280 Contractor Type Carrier Fiscal Intermediary A MAC A MAC B Effective Date: 03/18/2010 I. General Coding Psychiatry and Psychology are specialized fields for the diagnosis and treatment of various mental health disorders and/or diseases. References to providers include physicians and non-physicians, such as clinical psychologists, independent psychologists, nurse practitioners, clinical nurse specialists and physician assistances when the services performed are within the scope of their state license and clinical practice/education. Individual psychotherapy cpt codes should be used only when the focus of treatment involves individual psychotherapy.

Specifically, CPT codes 96105, 96110 and 96111 may be performed by these therapists. However, when PTs, OTs and SLPs perform these three tests, they must be performed under the general supervision of a physician or a CP. CPT code 96125 is used by OTs or SLP. Other providers should use the appropriate code CPT code from the 96101-96103 or 96118 ...

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