Psychotherapy & Psychiatric Diagnostic

90838 CPT

Psychotherapy, 60 minutes with E/M (add-on)

System

CPT code

Timing

Time-based — 60-min units

Add-on

Yes — needs a primary code

CPT 90838 is the add-on code for 60 minutes of psychotherapy delivered alongside an E/M service. It is the longest of the psychotherapy-with-E/M add-on codes.

When to use 90838

Add 90838 when roughly 53–67 minutes of psychotherapy accompanies an E/M service. The 30- and 45-minute equivalents are 90833 and 90836.

How to bill it

Bill as an add-on to a qualifying E/M code, documenting the therapy time separately from the medical portion. Payers may scrutinize extended sessions.

Common pitfalls

  • Using 90838 without a documented primary E/M service.
  • Not separating therapy time from E/M time in the note.

Frequently asked questions

When should I use 90838?

Use it when a prescriber delivers about 53–67 minutes of psychotherapy in addition to an E/M service on the same date of service.

Is documentation different for 90838?

Yes. Clearly document the E/M portion and the psychotherapy portion separately, including distinct start and stop times for therapy.

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