Behavioral CPT codes in 2021 have changed since the end of the previous year. Every year, code adjustments and updates take place to reflect changes in the industry and the necessities for billing. In order for behavioral health providers to ensure they are maximizing their payments from insurance payers, they need to stay up-to-date on the CPT codes for 2021.
Behavioral Health Billing
Behavioral health billing is a complex and ornate segment of a provider’s job that is extremely delicate and necessary to their success. With proper billing processes in place, providers can maximize their revenue, grow, and continue to help their patients.
The issue a lot of providers run into is that their billing is difficult and time-consuming, taking away from their patient attentiveness. Keeping current with the painstaking and particular billing requirements in the field is tedious and endless work for providers who did not enter the field to file claims. Although many providers dread the billing process, it is ultimately what funds their ability to keep caring for their patients.
For this reason, they need to stay up to date with the changes in CPT codes for 2021 and on.
Commonly Used CPT Codes for Behavioral Health Case Management
90832: 30 minutes of psychotherapy
90834: 45 minutes of psychotherapy
90837: 60 minutes of psychotherapy
90785: Interactive complexity add-on
90839: 60 minutes of psychotherapy for crisis
90840: Each additional 30 minutes of psychotherapy for crisis
90791: Psychiatric diagnostic evaluation
90846: 50 minutes of family psychotherapy without the patient present
90847: 50 minutes of family psychotherapy with the patient present
90853: Group psychotherapy
Telehealth – Due to the continuation of the pandemic, providers also need to remain aware of the current telehealth CPT codes for 2021. These codes include the
95 Modifier – This modifier is added to CPT codes for 2021 to label a real-time interaction between a provider and their patient via a telecommunications system (video conferencing).
02 for the place of service – Code 02 is used to describe the place of service, as a telecommunications system.
Updates to CPT Codes for 2021
Changes to CPT codes for 2021 include the following:
Instead of codes 96158 and 96151, providers should now use 96156 to bill for health and behavior assessment/reassessment. It is now event-based rather than the previous time-based.
Instead of code 96152, providers are now to use 96158 and 96159 to bill for an individual, face-to-face health behavior intervention for 30 minutes, and additional 15-minute increments.
Instead of code 96153, providers are now to use 96164 and 96165 to bill for face-to-face group health interventions for 30-minute and 15-minute increments.
Instead of code 96154, providers are now to use codes 96167 and 96168 to bill for face-to-face family health behavior intervention (patient is present) for 30-minute and 15-minute increments.
Instead of code 96155, providers are to use codes 96170 and 96171 to bill for face-to-face family health behavior intervention (patient is not present) for 30-minute and 15-minute increments.
Why Claims Get Denied
The most common reason for a claim to be denied is that it was coded incorrectly. Errors in coding happen quite frequently, mostly because a provider is not current with the latest changes like changes in CPT codes for 2021. Claim denials are a sure way to lose revenue. This is because a denied claim equals partial or no payment. While providers have the opportunity to resubmit claims, they can only do so within a certain window of time, which is different from every payer and is hard to keep track of.
Providers should consider utilizing billing services to improve their claims process and prevent money from slipping through the cracks.
How Billing Services Can Improve Your Claims Process
Rather than have to keep up with CPT codes for 2021, you can hand over your claims submission process to a team of expert billers. Their entire job is comprised of staying up to date with CPT codes for 2021 and on so that you do not have to. They know how to perfect each one of your claims for optimal chances of approval each time.
Should a denial happen, your billing services partner will handle that too. They will keep track of claims so that when a denial happens, it is immediately resubmitted with any necessary corrections so that no money slips through the cracks.
Another common source of denials is a client’s lack of coverage. Your billing services partner can check a patient’s eligibility so make sure they are covered for the services you are about to render.
Weekly Billing Summary and Reporting
Insights into your billing process are how you are able to improve it. A weekly billing summary, as well as reports, will help you better understand the billing process so you know where you stand and you know how to grow.
Changes in CPT codes for 2021 do not need to stress you out. With the right billing services partner, you can tackle your claims process while focusing more of your energy on your patients.
To learn more about an EHR that can help you streamline and organize your practice management, click here.