2025 CPT code 90876
(Active) Effective Date: N/A Revision Date: N/A Psychiatry - Other Psychiatric Services or Procedures Medicine Services and Procedures > Psychiatry Services and Procedures Feed
Individual psychophysiological therapy with biofeedback training and psychotherapy; 45 minutes.
Modifiers may be applicable depending on the circumstances of service. Review the CPT guidelines and modifier instructions for any applicable modifiers.
Medical necessity for this code is established when the patient presents with a diagnosable mental health condition that can be effectively treated by a combined approach of biofeedback and psychotherapy. The therapy should be appropriate to the patient's specific needs and contribute to measurable improvement in their symptoms and functioning.
The clinical responsibility lies with a qualified healthcare professional, such as a psychiatrist or psychologist, trained in both biofeedback and psychotherapy techniques.They conduct the session, guide the patient through biofeedback exercises, and provide therapeutic support through psychotherapy.
- Medicine Services and Procedures > Psychiatry Services and Procedures
- Medicine Services and Procedures > Psychiatry Services and Procedures > Other Psychiatric Services or Procedures
In simple words: This code covers a 45-minute therapy session combining biofeedback (learning to control your body's responses like heart rate) and talk therapy (discussing thoughts and feelings) to improve mental health.
This CPT code reports individual psychophysiological therapy that integrates biofeedback training (using any modality, face-to-face with the patient) and psychotherapy (e.g., insight-oriented, behavior modification, or supportive psychotherapy).The session duration is approximately 45-50 minutes. This combined approach addresses the interplay between physiological processes and psychological well-being.
Example 1: A patient with anxiety experiences significant physiological symptoms (increased heart rate, rapid breathing).The provider uses biofeedback to teach the patient to regulate their heart rate and breathing, combined with psychotherapy to address underlying anxieties and coping mechanisms., A patient with PTSD exhibits heightened muscle tension and sleep disturbances.Biofeedback helps the patient reduce muscle tension, and psychotherapy provides a safe space to process traumatic memories and develop healthy coping strategies., A patient with depression displays low energy levels and difficulty concentrating. Biofeedback helps increase focus and energy levels, while psychotherapy addresses cognitive distortions and emotional regulation issues.
Detailed documentation should include:* Patient demographics and presenting complaint.* Assessment of physiological symptoms and psychological distress.* Description of biofeedback techniques used (e.g., EMG, heart rate variability).* Documentation of patient's response to biofeedback and psychotherapy.* Treatment plan outlining goals, methods, and frequency of sessions.* Progress notes documenting the patient's progress over time.
** This code is reported per 45-minute session.Multiple units may be reported for longer sessions, if appropriate.The use of biofeedback modalities is not specified and can include various options (e.g., EMG, GSR, heart rate variability).
- Revenue Code: M5B (SPECIALIST - PSYCHIATRY)
- RVU: The RVUs for this code will vary based on geographic location, facility type (non-facility or facility), and the specific payer's conversion factor.Consult the relevant fee schedule for precise RVU values and reimbursement rates.
- Global Days: The global period for this code is not explicitly defined in the provided sources.Further clarification is needed to determine if a global surgical period is applicable.
- Payment Status: Active
- Modifier TC rule: The provided sources do not specify whether a Technical Component (TC) modifier applies.The application of a TC modifier depends on the specific billing circumstances.
- Fee Schedule: The provided sources do not include historical fee schedule data. Refer to specific payer fee schedules for reimbursement rates across different time periods.
- Specialties:Psychiatry, Psychology
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital, Other Place of Service (as clinically appropriate)