2025 CPT code 90836
(Active) Effective Date: N/A Psychiatry - Psychotherapy Feed
Individual psychotherapy, lasting 38-52 minutes, performed with an evaluation and management (E/M) service.
Modifiers, such as modifier 25 (significant, separately identifiable E/M service by the same physician on the same day of the procedure or other service), and telehealth modifiers GT or 95 might be applicable depending on the specific circumstances.
Medical necessity for both the E/M service and the psychotherapy session must be clearly documented.The psychotherapy should be a necessary component of the patient's treatment plan and contribute to their overall mental health improvement.
The physician or other qualified healthcare professional provides psychotherapy services, including assessment, treatment planning, and therapeutic communication, to address the patient's mental health needs. This may involve individual or family sessions.
In simple words: This code covers a 38-52 minute psychotherapy session with your doctor or therapist, when it's done along with a separate medical evaluation and management visit during the same appointment.
This add-on code represents individual psychotherapy, primarily insight-oriented, behavior-modifying, and/or supportive, with a duration of 38-52 minutes (typically 45 minutes) when performed in conjunction with an E/M service.It includes time spent with the patient and/or family member. The E/M service is reported separately.This code is for use by psychiatrists and other qualified healthcare professionals.
Example 1: A patient with generalized anxiety disorder receives a medication check-up (E/M service) followed by a 45-minute psychotherapy session to discuss coping mechanisms., A patient with major depressive disorder has a 40-minute psychotherapy session combined with an E/M service for medication management., A patient with bipolar disorder is seen for a 50-minute psychotherapy session (along with an E/M visit) to address mood stabilization and medication adherence.
Documentation should include the start and end times of the psychotherapy session, the total time spent, the content and focus of the therapy (e.g., specific issues discussed, interventions used), patient progress or lack thereof, and any involvement of family members.The separate E/M service should also be documented appropriately.
- Payment Status: Active
- Modifier TC rule: No TC modifier is applicable to this code.
- Specialties:Psychiatry, Clinical Psychology, Licensed Clinical Social Work
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital, Partial Hospitalization Program, telehealth (with modifier GT or 95)