There are two changes in the psychiatry section of CPT for 2017. The first is the description of psychotherapy codes were revised to remove the words “and/or family.” In 2016, CPT code 90832 was defined as “Psychotherapy, 30 minutes with patient and/or family member.” In 2017 the definition is “Psychotherapy, 30 minutes with patient.” Codes 90833, 90834, 90836, 90837, 90838, and 90839 were similarly revised.
The CPT Changes Insider’s View 2017 notes that although another person may be in the room (and they label this person as an “informant”) the individual psychotherapy codes are for individual treatment and the patient must be in the room “for all or a majority of the service.” The therapy focus is on the individual, not the family, even if the family member is present for part of the session and provides information. Therapy focused on the family should be reported with family therapy codes. According to CPT, individual and family therapy may be reported on the same day, although your payer may not follow that coding rule.
Family psychotherapy now has time added to the description.
CPT code 90846 was revised from “Family psychotherapy (without the patient present),” to “Family psychotherapy (without the patient present), 50 minutes.”
CPT code 90847 was revised from “Family psychotherapy (conjoint therapy) (with the patient present),” to “Family psychotherapy (conjoint therapy) (with the patient present), 50 minutes.”
Psychotherapy codes follow the CPT time rule, which is that in order to bill the service, the clinician must meet the mid point of time. In this case, in order to bill either 90846 or 90847, the family therapy must be at least 26 minutes. As always, document time in the medical record when time is a descriptor.
CPT is making a clearer distinction between individual and family therapy.