CPT Code 90833 Can Be Added to 99204
Yes, you can add CPT code 90833 (psychotherapy, 30 minutes) to CPT code 99204 (new patient office visit, comprehensive). 1
Coding Rationale and Requirements
The American Academy of Child and Adolescent Psychiatry guidelines explicitly list both 90833 and 99204 as compatible codes that can be used together for billing purposes. According to these guidelines, the GT modifier "95" can be used for services provided in CPT Appendix P, which specifically includes both codes 90833 and 99204 among others 1.
When using these codes together:
- Code 99204 represents: A comprehensive new patient evaluation and management service
- Code 90833 represents: 30 minutes of psychotherapy provided in addition to the E/M service
Provider Eligibility Considerations
It's important to note that not all practitioners can bill for code 90833:
Eligible providers: Physicians, physician assistants, nurse practitioners, nurse-midwives, and clinical nurse specialists can bill for both 99204 and 90833 1
Ineligible providers: Clinical psychologists (CPs) and clinical social workers (CSWs) cannot bill for psychotherapy services that include medical services or medical evaluation and management services under Medicare. These practitioners specifically may not bill or receive payment for CPT code 90833 1
Documentation Requirements
When billing both codes together, ensure your documentation clearly shows:
- The elements required for the 99204 E/M service (comprehensive history, comprehensive examination, and moderate medical decision complexity)
- A separately identifiable 30-minute psychotherapy service
- That both services were provided during the same encounter
Common Pitfalls to Avoid
Time overlap: Ensure the time spent on psychotherapy is separate from the time spent on the E/M service. The same time cannot be counted twice.
Documentation separation: Clearly document the elements of both services separately to justify both codes.
Provider qualification: Verify that the provider has the appropriate qualifications to bill for psychotherapy services.
Modifier usage: When providing these services via telehealth, remember to append the appropriate telehealth modifier ("95") to indicate services were provided using telemedicine technology 1.
By following these guidelines, you can appropriately bill both CPT code 90833 and 99204 for the same encounter when providing both evaluation and management services and psychotherapy to a patient.