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CPT Code 90863

  1. Unhappy CPT Code 90863
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    Is CPT Code 90863 covered by Medicare?

  2. #2
    from what I've found it says that it's not recognized by medicare for oupatient claims and it's status E-- non-allowed item or service

    (it's also an add on code so it would have to go with 90832 etc for other insurances)

    hope that helps

  3. Default Is CPT Code 90863 covered by Medicare?
    No, 90863 is Pharmacologic management, including prescription and review of medication, when performed with psychotherapy services; used only as add-on to primary psychotherapy code (90832, 90834, 90837). This code was introduced to replace 90862 in January 2013, and is meant for Medical Psychologists, or Psychologists with prescriptive rights. Since Medical Psychologists are not universally recognized by payers, this is a way for them to get paid for their services. If they are recognized, the can use 99-codes, just like Psychiatrists, NPs and other mental health providers.

  4. #4
    Can someone confirm that if a provider is 'managing psych meds' as part of either Transitional Care Management or E/M services, it is not separately billable?

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