Understanding Billing Codes
CPT Codes
CPT Codes are used for individual providers, such as those in private practice. CPT Codes are billed on the CMS-1500 Form, also called the “HCFA.” Even if you do not accept insurance, if a client has a PPO insurance plan, they may receive some reimbursement for services. For clients with PPO insurance, you may print a “superbill” which has the CPT code on the form. You may also provide a patient with a pre-printed CMS-1500 form, which are available on Amazon.
Here are some examples of CPT Codes, with sample rates:
| CPT CODE | DESCRIPTION | BILLING AMOUNT |
|---|---|---|
| 0 | none | $0 |
| 90792 | Psychiatric Diagnostic Evaluation (with Medical Services) | $300 |
| 90833 | ADD ON-30 Min Psychotherapy | $50 |
| 90837 | Psychotherapy 60 min (53+ min) | $180 |
| 90838 | ADD ON-60 Min Psychotherapy | $100 |
| 90839 | Psychotherapy (Crisis) | $340 |
| 97813 | Acupuncture with Electrical Stimulation – 15 Minutes | $50 |
| 97814 | Acupuncture with Electrical Stimulation – Additional 15 Minutes | $50 |
| 99205 | Psychiatry 60 min Follow-Up E&M | $300 |
| 99215 | Psychiatry 30 min Follow-Up E&M | $150 |
| G0434 | Drug Testing, EtG/EtS Urine Alcohol | $85 |
| G0434 | Drug Testing, Urine Drug Screen (DSC6309) | $25 |
HCPCS Codes
Facility codes, also known as HCPCS Codes, are used by hospitals, intensive outpatient treatment centers, and other facilities. These codes are billed on the UB-04 form. UB-04 Forms are also available on Amazon. Most private practitioners will not need to use the UB-04 or do any facility billing.
Practice Private 