CPT Code Changes Coming
September 28, 2012

The American Medical Association (AMA) announced the release of changes to the Current Procedural Terminology (CPT) code set that includes significant changes for psychiatric services. New codes are effective January 1, 2013. According to the AMA, “input from the health care community has allowed CPT to better support the reporting needs of physicians and others participating in emerging models of care, such as a patient-centered medical home, accountable care organization and other novel integrated delivery systems. CPT changes better capture the work involved in managing patients with complex chronic conditions within one of the new integrated delivery systems.” 

Changes to CPT codes were discussed during the September PCPA Mental Health Committee meeting. Little information was known about the changes at that time, although there was speculation that medication checks could only be done by physicians and the role of the nurse would be eliminated. There was also speculation that injections administered by nurses would be impacted. National Council is completing analysis of the changes. It will also develop training on the code changes. PCPA may also develop training.

An American Psychiatric Association summary of changes notes:

• Elimination of all current 908xx psychotherapy codes – to be replaced with a combination of evaluation and management (E/M) codes (99xxx series) plus new psychotherapy add-on codes. The combination codes are only for physicians.
• Creation of new non-medical psychotherapy codes for psychologists and social workers – Physicians would be permitted to use the codes, but the reimbursement rate is significantly lower.
• Elimination of 90862 – to be replaced with E/M codes.
• Bifurcation of 90801 into two categories – one for physicians and one for psychologists and social workers.

A crosswalk of 2012 to 2013 codes developed by the American Psychiatric Association provides some detail.

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