Recent
- CarePaths Helps California Providers Comply With New E-Prescription Mandate
- No Surprises Act: What does it mean for behavioral health?
- CarePaths is Hiring - Practice Success Team
- A New Path Forward: CarePaths Re-Imagining Practice Building Through New Technology & Leadership
- Crossroads for Behavioral Clinicians: ONC-Certified EHR or the Silo?
Archive
- May 2022
- January 2022
- December 2021
- October 2021
- May 2021
- April 2021
- January 2021
- September 2020
- July 2020
- May 2020
- February 2020
- November 2018
- September 2018
- August 2018
- July 2018
- April 2018
- March 2018
- February 2018
- December 2017
- November 2017
- September 2017
- August 2017
- July 2017
- May 2017
- April 2017
- March 2017
- February 2017
- December 2016
- September 2016
- July 2016
- April 2016
- February 2016
- December 2015
- October 2015
- September 2015
- June 2015
- May 2015
- April 2015
- March 2015
- February 2015
- January 2015
- December 2014
- November 2014
- October 2014
- September 2014
- July 2014
- June 2014
- May 2014
- April 2014
- March 2014
- February 2014
- January 2014
- December 2013
- November 2013
- October 2013
Should You Be Using CPT 90837 More Often?
If you are hesitant to bill CPT (CPT copyright 2020 American Medical Association. All rights reserved)* 90837 rather than 90834 read this blog. You will find out how often other therapists use this code, how much insurance companies pay, and how often they deny. We will also provide payer-specific data on denials and reimbursement.
In 2013, the traditional CPT code used for psychotherapy sessions, “the fifty-minute hour,” was retired and replaced by two new codes, 90834 for sessions of 37-52 minutes, and 90847 for sessions or 53 minutes or longer.
How Much More Money?
Most payers reimburse more for 90837 than for 90834. The chart below shows data for over a million claims submitted to the CarePaths EHR since 2013.
The payment advantage of 90837 has increased since 2013 and is now over $29/session more than 90834.
What About Claims Denials and Reimbursements?
Denial rates are low for both 90834 and 90837. In 2019 denial rate for 90834 was 0.7% and 1.8% for 90837. But the variation in denial rates between payers is significant.
Also significant is variation in reimbursement between payers.
If you’d like to see how your payers stack up in denial rates and reimbursement, you can view our entire data set by clicking here. Search either by “Payer ID” or “Payer Name.”
*CPT copyright 2020 American Medical Association. All rights reserved.