Psychiatry Coding & Reimbursement Alert

Question: I am looking for information on billing hypnotherapy. Should we use the CPT® code 90880 or should we use a psychotherapy code if our clinician performs this along with hypnotherapy?

Illinois Subscriber

Answer: Some payers do not provide coverage for hypnotherapy. So, it is best to obtain details about whether or not the particular payer is providing coverage for the procedure to help you avoid the possibility of denials.

You will also need to bear in mind hypnotherapy will be covered only when your clinician performs it for a covered diagnosis. Hence, you might check to see if the particular diagnosis for which your clinician is performing the service is covered or not.

Warning: You should always report the code that corresponds to the physician’s documentation, no matter if it is covered or not.

Next, you need to determine if your clinician is performing the service as a standalone treatment or if it is conjoined with any other therapy such as psychotherapy. If the service is a standalone session, then you report it with 90880 (Hypnotherapy).

But, if your clinician is performing hypnotherapy with psychotherapy, then you will need to know that these codes will face bundling edits, according to Correct Coding Initiative (CCI). As psychotherapy codes (90832-90838) are column 2 codes with 90880 and because the modifier indicator is ‘0,’ you are not allowed to report the psychotherapy code with 90880 for the same patient on the same calendar date of service, if the payer is following CCI edits.

If you report any psychotherapy code with 90880 on the same date for the same patient, the psychotherapy code will be denied, and only the hypnotherapy code will be paid.

Coding tip: You are also not allowed to report an E/M service with hypnotherapy, because these code sets also face bundling by CCI. The E/M code form column 2 codes with hypnotherapy and with the modifier indicator ‘0,’ so these edits cannot be overridden with the help of a modifier.