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2025 CPT code 0820T

Continuous in-person monitoring and intervention during psychedelic medication therapy; first physician or other qualified health care professional, per hour.

This is a Category III code; payer coverage and acceptance may vary. Follow all applicable CPT coding guidelines.Accurate time records are essential for billing.

Modifiers may be applicable depending on the circumstances of service delivery. Consult the CPT manual and payer-specific guidelines.

Medical necessity is established by the patient's diagnosis and the need for continuous in-person monitoring and intervention due to the inherent risks associated with psychedelic medication therapy.Clinical documentation must support the necessity of the service provided.

The provider supervises psychedelic medication self-administration, monitors the patient continuously for physical, emotional, and psychological changes, and intervenes as needed to ensure safety and optimize treatment outcomes.

IMPORTANT Use +0821T for a second physician or QHP, and +0822T for concurrent clinical staff participation. Do not report with 90832-90840, 96116, 96121, 97151-97158, 99415-99416 on the same date.

In simple words: A doctor or other qualified healthcare professional watches over a patient closely and helps them during treatment with psychedelic drugs. This is because these drugs can cause emotional and physical problems.The doctor is paid for each hour of this care.

This CPT Category III code reports the total duration of in-person time spent by the first physician or qualified healthcare professional (QHP) providing continuous monitoring and intervention, as needed, during psychedelic medication therapy.The service addresses the potential emotional and physiological risks associated with psychedelic medications, which may persist for several hours.The provider supervises self-administration, monitors the patient, and intervenes to support physical, emotional, and psychological safety, optimizing treatment outcomes.This code is reported per hour and should not be used with codes 90832-90840, 96116, 96121, 97151-97158, 99415-99416 on the same date of service.

Example 1: A psychiatrist supervises a patient undergoing psilocybin therapy for treatment-resistant depression. The psychiatrist provides continuous monitoring and intervention for 4 hours, billing 4 units of 0820T., A patient receiving MDMA-assisted therapy for PTSD experiences a challenging emotional breakthrough.The supervising therapist utilizes 0820T to bill for 2 hours of continuous monitoring and intensive intervention to ensure patient safety and support the therapeutic process., A patient receiving ketamine infusion therapy for treatment-resistant depression experiences unexpected adverse effects. The supervising physician and nurse use 0820T and 0822T, respectively, to bill for their concurrent participation in managing the situation.

Detailed medical record notes documenting the patient's condition before, during, and after psychedelic medication administration.Documentation should include the type of medication, dosage, duration of monitoring, interventions provided (including psychotherapy or crisis intervention), patient's response to medication and interventions, and any adverse events. Time records should support the number of units of 0820T billed.

** This code is intended for use in a therapeutic setting where continuous monitoring and intervention are provided during and following psychedelic medication administration.Always refer to the most current CPT codebook for the latest information and guidelines.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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