Billing for Psychotherapy and Evaluation and Management Services

Understanding the CPT Code Structure

The American Academy of Child and Adolescent Psychiatry recommends that CPT code 90836 is a "combination code" that already bundles psychotherapy with evaluation and management services, and billing 90836 and 99215 together on the same day constitutes double billing for overlapping services 1, 2
The American Academy of Child and Adolescent Psychiatry states that when you bill 90836, you are already being reimbursed for the E/M portion, and adding 99215 would mean billing twice for the same work 1, 2

The American Academy of Child and Adolescent Psychiatry recommends billing 90836 (or 90833/90838 depending on time spent) as the primary code when providing psychotherapy with medical E/M services, as this single code captures both components of work 1, 2
The American Academy of Child and Adolescent Psychiatry advises against adding any 99211-99215 codes when billing 90836, as this would result in double billing for overlapping services 1, 2

The American Academy of Sleep Medicine notes that clinical psychologists and clinical social workers cannot bill CPT codes 90833, 90836, or 90838 under Medicare, as these practitioners are not permitted to bill for services that include medical evaluation and management 5, 6

The American Academy of Child and Adolescent Psychiatry requires that documentation for billing 90836 must support the psychotherapy component, the medical E/M component, total time spent, and clear indication that both psychotherapy and medical management were medically necessary 1, 2

The American Academy of Child and Adolescent Psychiatry states that for telehealth services, both psychotherapy and E/M codes can be billed with modifier 95, but the same bundling rules apply, and 90836 already includes E/M, so adding 99215 remains inappropriate even via telemedicine 1, 2