SPECIALIZED BEHAVIORAL HEALTH SERVICES - CPT Codes (V3 ...

1 V7 10/1/20201 CodeDescriptionAgePsychiatristAPRN/CNS/P AMedical PsychologistPsychologistLCSWLPCLMFTLACHA =ChildHB=AdultAFSAHPAHAJHOHOHF90785 INTERACTIVE COMPLEXITY, ADD ON 0-20$ $ $ $ $ $ $ COMPLEXITY, ADD ON 21+$ $ $ $ $ $ $ DIAGNOSTIC EVALUATION 0-20$ $ $ $ $ $ $ DIAGNOSTIC EVALUATION 21+$ $ $ $ $ $ $ DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES0-20$ $ $ DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES21+$ $ $ , 30 MINUTES WITH PATIENT PRESENT0-20$ $ $ $ $ $ $ $ , 30 MINUTES WITH PATIENT PRESENT21+$ $ $ $ $ $ $ $ , 30 MINUTES WITH PATIENT PRESENT, ADD ON0-20$ $ $ , 30 MINUTES WITH PATIENT PRESENT, ADD ON21+$ $ $ , 45 MINUTES WITH PATIENT PRESENT0-20$ $ $ $ $ $ $ $ , 45 MINUTES WITH PATIENT PRESENT21+$ $ $ $ $ $ $ $ , 45 MINUTES WITH PATIENT PRESENT, ADD ON0-20$ $ $ , 45 MINUTES WITH PATIENT PRESENT, ADD ON21+$ $ $ , 60 MINUTES WITH PATIENT PRESENT0-20$ $ $ $ $ $ $ , 60 MINUTES WITH PATIENT PRESENT21+$ $ $ $ $ $ $ , 60 MINUTES WITH PATIENT PRESENT, ADD ON0-20$ $ $ , 60 MINUTES WITH PATIENT PRESENT, ADD ON21+$ $ $ FOR CRISIS; FIRST 60 MINUTES0-20$ $ $ $ $ $ $ $ FOR CRISIS; FIRST 60 MINUTES21+$ $ $ $ $ $ $ $ FOR CRISIS.

2 EACH ADDITIONAL 30 MINUTE ADD ON0-20$ $ $ $ $ $ $ $ FOR CRISIS; EACH ADDITIONAL 30 MINUTE ADD ON21+$ $ $ $ $ $ $ $ PSYCHOANALYSIS 0-20$ PSYCHOANALYSIS 21+$ PSYCHOTHERAPY WITHOUT PATIENT PRESENT0-20$ $ $ $ $ $ $ $ PSYCHOTHERAPY WITHOUT PATIENT PRESENT21+$ $ $ $ $ $ $ $ PSYCHOTHERAPY WITH PATIENT PRESENT0-20$ $ $ $ $ $ $ $ PSYCHOTHERAPY WITH PATIENT PRESENT21+$ $ $ $ $ $ $ $ FAMILY GROUP PSYCHOTHERAPY 0-20$ $ $ $ FAMILY GROUP PSYCHOTHERAPY 21+$ $ $ $ PSYCHOTHERAPY0-20$ $ $ $ $ $ $ $ PSYCHOTHERAPY21+$ $ $ $ $ $ $ $ MANAGEMENT ADD ON0-20$ MANAGEMENT ADD ON21+$ THERAPY 0-20$ THERAPY 21+$ THERAPY WITH

3 BIOFEEDBACK 20-30 MINUTES0-20$ THERAPY WITH BIOFEEDBACK 20-30 MINUTES21+$ THERAPY WITH BIOFEEDBACK 45-50 MINUTES0-20$ THERAPY WITH BIOFEEDBACK 45-50 MINUTES21+$ HYPNOTHERAPY 0-20$ $ $ HYPNOTHERAPY 21+$ $ $ OF APHASIA 0-20$ OF APHASIA 21+$ STATUS EXAMINATION, FIRST HOUR0-20$ STATUS EXAMINATION, FIRST HOUR21+$ STATUS EXAMINATION, EACH ADDITIONAL HOUR0-20$ STATUS EXAMINATION, EACH ADDITIONAL HOUR21+$ TESTING EVALUATION SERVICES BY PHYSICIAN/QHP, FIRST HOUR0-20$ $ $ TESTING EVALUATION SERVICES BY PHYSICIAN/QHP, FIRST HOUR21+$ $ $ TESTING EVALUATION SERVICES BY PHYSICIAN/QHP, EACH ADDITIONAL HOUR0-20$ $ $ TESTING EVALUATION SERVICES BY PHYSICIAN/QHP, EACH ADDITIONAL HOUR21+$ $ $ TESTING EVALUATION SERVICES BY PHYSICIAN/QHP, FIRST HOUR0-20$ $ $ TESTING EVALUATION SERVICES BY PHYSICIAN/QHP, FIRST HOUR21+$ $ $ TESTING EVALUATION SERVICES BY PHYSICIAN/QHP, EACH ADDITIONAL HOUR0-20$ $ $ TESTING EVALUATION SERVICES BY PHYSICIAN/QHP, EACH ADDITIONAL HOUR21+$ $ $ OR NEUROPSYCH TEST ADMIN/SCORING BY PHYSICIAN/QHP, 2 OR MORE TESTS, FIRST 30 MINUTES0-20$ $ $ OR NEUROPSYCH TEST ADMIN/SCORING BY PHYSICIAN/QHP.

4 2 OR MORE TESTS, FIRST 30 MINUTES21+$ $ $ OR NEUROPSYCH TEST ADMIN/SCORING BY PHYSICIAN/QHP, 2 OR MORE TESTS, EACH ADDITIONAL 30 MINUTES0-20$ $ $ OR NEUROPSYCH TEST ADMIN/SCORING BY PHYSICIAN/QHP, 2 OR MORE TESTS, EACH ADDITIONAL 30 MINUTES21+$ $ $ BEHAVIORAL HEALTH SERVICES - CPT Codes Effective >V7 10/1/20202 CodeDescriptionAgePsychiatristAPRN/CNS/P AMedical PsychologistPsychologistLCSWLPCLMFTLACSP ECIALIZED BEHAVIORAL HEALTH SERVICES - CPT Codes Effective OR NEUROPSYCH TEST ADMIN AND SCORING BY TECHNICIAN, FIRST 30 MINUTES0-20$ $ $ OR NEUROPSYCH TEST ADMIN AND SCORING BY TECHNICIAN, FIRST 30 MINUTES21+$ $ $ OR NEUROPSYCH TEST ADMIN AND SCORING BY TECHNICIAN, EACH ADDITIONAL 30 MINUTES0-20$ $ $ OR NEUROPSYCH TEST ADMIN AND SCORING BY TECHNICIAN, EACH ADDITIONAL 30 MINUTES21+$ $ $ OR NEUROPSYCHOLOGICAL TEST ADMIN WITH SINGLE AUTOMATED INSTRUMENT, AUTO RESULTS ONLY0-20$ $ $ OR NEUROPSYCHOLOGICAL TEST ADMIN WITH SINGLE AUTOMATED INSTRUMENT, AUTO RESULTS ONLY21+$ $ $ BEHAVIOR ASSESSMENT/REASSESSMENT0-20$ $ $ $ BEHAVIOR ASSESSMENT/REASSESSMENT21+$ $ $ BEHAVIOR INTERVENTION, INDIVIDUAL, FACE-TO-FACE; FIRST 30 MINUTES0-20$ $ $ BEHAVIOR INTERVENTION, INDIVIDUAL, FACE-TO-FACE.

5 EACH ADDITIONAL 15 MINUTES0-20$ $ $ BEHAVIOR INTERVENTION, INDIVIDUAL, FACE-TO-FACE; FIRST 30 MINUTES21+$ $ $ BEHAVIOR INTERVENTION, INDIVIDUAL, FACE-TO-FACE; EACH ADDITIONAL 15 MINUTES21+$ $ $ BEHAVIOR INTERVENTION, GROUP, FACE-TO-FACE; FIRST 30 MINUTES0-20$ $ $ BEHAVIOR INTERVENTION, GROUP, FACE-TO-FACE; EACH ADDITIONAL 15 MINUTES0-20$ $ $ BEHAVIOR INTERVENTION, GROUP, FACE-TO-FACE; FIRST 30 MINUTES21+$ $ $ BEHAVIOR INTERVENTION, GROUP, FACE-TO-FACE; EACH ADDITIONAL 15 MINUTES21+$ $ $ BEHAVIOR INTERVENTION, FAMILY WITH PATIENT PRESENT, FACE-TO-FACE; FIRST 30 MINUTES0-20$ $ $ BEHAVIOR INTERVENTION, FAMILY WITH PATIENT PRESENT, FACE-TO-FACE; EACH ADDITIONAL 15 MINUTES0-20$ $ $ BEHAVIOR INTERVENTION, FAMILY WITH PATIENT PRESENT, FACE-TO-FACE; FIRST 30 MINUTES21+$ $ $ BEHAVIOR INTERVENTION, FAMILY WITH PATIENT PRESENT, FACE-TO-FACE; EACH ADDITIONAL 15 MINUTES21+$ $ $ BEHAVIOR INTERVENTION, FAMILY WITHOUT PATIENT PRESENT, FACE-TO-FACE; FIRST 30 MINUTES0-20$ $ $ BEHAVIOR INTERVENTION, FAMILY WITHOUT PATIENT PRESENT, FACE-TO-FACE; EACH ADDITIONAL 15 MINUTES0-20$ $ $ BEHAVIOR INTERVENTION, FAMILY WITHOUT PATIENT PRESENT, FACE-TO-FACE.

6 FIRST 30 MINUTES21+$ $ $ BEHAVIOR INTERVENTION, FAMILY WITHOUT PATIENT PRESENT, FACE-TO-FACE; EACH ADDITIONAL 15 MINUTES21+$ $ $ , PROPHYLACTIC OR DIAGNOSTIC INJECTION0-20$ $ $ , PROPHYLACTIC OR DIAGNOSTIC INJECTION21+$ $ $ PATIENT OFFICE OUTPATIENT - PROBLEM FOCUSED (10 Min)0-20$ $ $ PATIENT OFFICE OUTPATIENT - PROBLEM FOCUSED (10 Min)21+$ $ $ PATIENT OFFICE OUTPATIENT - EXPANDED PROBLEM FOCUSED (20 Min)0-20$ $ $ PATIENT OFFICE OUTPATIENT - EXPANDED PROBLEM FOCUSED (20 Min)21+$ $ $ PATIENT OFFICE OUTPATIENT - DETAILED (30 Min)0-20$ $ $ PATIENT OFFICE OUTPATIENT - DETAILED (30 Min)21+$ $ $ PATIENT OFFICE OUTPATIENT - COMPREHENSIVE MODERATE COMPLEXITY (45 Min)

7 0-20$ $ $ PATIENT OFFICE OUTPATIENT - COMPREHENSIVE MODERATE COMPLEXITY (45 Min)21+$ $ $ PATIENT OFFICE OUTPATIENT - COMPREHENSIVE HIGH COMPLEXITY (60 Min)0-20$ $ $ PATIENT OFFICE OR OTHER OUTPATIENT - COMPREHENSIVE HIGH COMPLEXITY (60 Min)21+$ $ $ PATIENT OFFICE OUTPATIENT - MINIMAL PROBLEMS (5 Min) 0-20$ $ $ PATIENT OFFICE OUTPATIENT - MINIMAL PROBLEMS (5 Min) 21+$ $ $ PATIENT OFFICE OUTPATIENT - PROBLEM FOCUSED (10 Min)0-20$ $ $ PATIENT OFFICE OUTPATIENT - PROBLEM FOCUSED (10 Min)21+$ $ $ PATIENT OFFICE OUTPATIENT - EXPANDED PROBLEM FOCUSED (15 Min)0-20$ $ $ PATIENT OFFICE OUTPATIENT - EXPANDED PROBLEM FOCUSED (15 Min)21+$ $ $ PATIENT OFFICE OUTPATIENT - DETAILED (25 Min)0-20$ $ $ PATIENT OFFICE OUTPATIENT - DETAILED (25 Min)21+$ $ $ PATIENT OFFICE OUTPATIENT - COMPREHENSIVE HIGH COMPLEXITY (40 Min)0-20$ $ $ PATIENT OFFICE OUTPATIENT - COMPREHENSIVE HIGH COMPLEXITY (40 Min)21+$ $ $ OBSERVATION CARE - LOW COMPLEXITY (30 Min)0-20$ $ $ OBSERVATION CARE - LOW COMPLEXITY (30 Min)21+$ $ $ OBSERVATION CARE - MODERATE COMPLEXITY (50 Min)0-20$ $ $ OBSERVATION CARE - MODERATE COMPLEXITY (50 Min)21+$ $ $ OBSERVATION CARE - HIGH COMPLEXITY (70 Min)

8 0-20$ $ $ OBSERVATION CARE - HIGH COMPLEXITY (70 Min)21+$ $ $ HOSPITAL INPATIENT CARE, LOW COMPLEXITY (30 Min)0-20$ $ $ HOSPITAL INPATIENT CARE, LOW COMPLEXITY (30 Min)21+$ $ HOSPITAL INPATIENT CARE, MODERATE COMPLEXITY (50 Min)0-20$ $ $ HOSPITAL INPATIENT CARE, MODERATE COMPLEXITY (50 Min)21+$ $ HOSPITAL INPATIENT CARE, HIGH COMPLEXITY (70 Min)0-20$ $ $ HOSPITAL INPATIENT CARE, HIGH COMPLEXITY (70 Min)21+$ $ HOSPITAL INPATIENT CARE, LOW (15 Min)0-20$ $ $ HOSPITAL INPATIENT CARE, LOW (15 Min)21+$ $ $ HOSPITAL INPATIENT CARE, MODERATE (25 Min)0-20$ $ $ HOSPITAL INPATIENT CARE, MODERATE (25 Min)21+$ $ $ 10/1/20203 CodeDescriptionAgePsychiatristAPRN/CNS/P AMedical PsychologistPsychologistLCSWLPCLMFTLACSP ECIALIZED BEHAVIORAL HEALTH SERVICES - CPT Codes Effective HOSPITAL INPATIENT CARE, HIGH (35 Min)0-20$ $ $ HOSPITAL INPATIENT CARE, HIGH (35 Min)21+$ $ $ OBSERVATION OR INPATIENT CARE - LOW (40 Min)0-20$ $ $ OBSERVATION OR INPATIENT CARE - LOW (40 Min)21+$ $ $ OBSERVATION OR INPATIENT CARE - MODERATE (50 Min)0-20$ $ $ OBSERVATION OR INPATIENT CARE - MODERATE (50 Min)21+$ $ $ OBSERVATION OR INPATIENT CARE - HIGH (55 Min)

9 0-20$ $ $ OBSERVATION OR INPATIENT CARE - HIGH (55 Min)21+$ $ $ DISCHARGE DAY MANAGEMENT (<30 Min)0-20$ $ $ DISCHARGE DAY MANAGEMENT (<30 Min)21+$ $ $ DISCHARGE DAY (>30 Min) 0-20$ $ $ DISCHARGE DAY (>30 Min) 21+$ $ $ DEPARTMENT VISIT, SELF LIM0-20$ $ $ DEPARTMENT VISIT, SELF LIM21+$ $ $ DEPARTMENT VISIT, LOW 0-20$ $ $ DEPARTMENT VISIT, LOW21+$ $ $ DEPARTMENT VISIT, MODERATE0-20$ $ $ DEPARTMENT VISIT, MODERATE21+$ $ $ DEPARTMENT VISIT, PROBLEM 0-20$ $ $ DEPARTMENT VISIT, PROBLEM 21+$ $ $ DEPARTMENT VISIT, PROBLEM EXPANDED0-20$ $ $ DEPARTMENT VISIT, PROBLEM EXPANDED21+$ $ $ AND/OR DRUG SCREENING AND BRIEF INTERVENTION (15-30 Min)0-20$ $ $ AND/OR DRUG SCREENING AND BRIEF INTERVENTION (15-30 Min)

10 21+$ $ $ TGPSYCHOLOGICAL OR NEUROPSYCH TEST ADMIN/SCORING BY PHYSICIAN/QHP, 2 OR MORE TESTS, FIRST