What is the rationale for classifying CPT code 90832 (psychotherapy 30-minutes) as "care or support"?

[ghost]

For example, would CBT for Insomnia be considered “care or support”? CBT-I sessions are often 30 minutes yet they are an EBP. Also – for the most part, PCMHI visits are set at 30 minutes. And, frequently short-term psychotherapy (not care / support) takes place in these 30 minute slots. When I select clinics by using the 534 stop code, a significant amount of their work is being categorized as care/support.

[ghost]

After talking with physicians, the most conservative thing is to assume that the 90832 CPT codes are probably being used in some form of ongoing care coordination way across the team and are probably not problem focused evidence based psychotherapy sessions taking place in these 30 minutes.

You do get some PCMHI teams that are doing evidence based practice. These data are tracked so that everyone knows they are being included in a care coordination bin.

[lzim]

Thanks @epearman

• We grouped 90832 30-min psychotherapy encounters with other encounters with similar visit lengths based on the most commonly reported usage of 90832 when reviewed with patient, provider and program or policy leads over the last 8 years.

• Anyone can check how all CPT-coded encounters are binned in the Data UI in the CPT Cheatsheet or in the dataEnc tab at mtl.how/data. This is designed to be transparent so teams can evaluate the strengths and weaknesses of each part of the data related to local needs and goals. For example, use of this encounter code can be discussed in relation to a particular team and understand how they use 90832 locally based on their type of team and staffing (e.g., PCMHI, BHIP, etc.).

• There are two goals of making these groupings transparent for ongoing improvement/updates as needed:

  1. participatory learning - The way we improve resources used for decision-making is through a process of mutual learning over time. This is possible with transparent resources.
  2. systems thinking - The way we improve the flow of patients through care and toward improvement is by upgrading care decisions based on better understanding of patients flow through care over time. This is possible by translating common care problems into units of time (e.g., patients/week or hours/week) so clinicians can improve their care episodes and plans.