Short answer
Thrizer can support claim submission when a session can be structured with a supported CPT code structure, a diagnosis code, provider information, service details, and a billed amount. Using a CPT code in Thrizer does not guarantee that an insurance plan will cover the service, approve the claim, apply the amount to the client’s deductible, or issue reimbursement. The insurance carrier makes those decisions after the claim is processed. Most standard psychotherapy CPT codes can be used in Thrizer workflows. Some testing, crisis, health behavior, medication management, rehabilitation, speech, nutrition, acupuncture, and other service codes may also be compatible, but they may require review depending on the service, provider type, and code combination.How CPT codes work in Thrizer
A CPT code tells the insurance carrier what type of service was provided. For a charge to be submitted as a claim through Thrizer, the charge generally needs:- a CPT code structure
- a diagnosis code
- provider information, including a valid NPI
- service date and appointment details
- billed amount
- client insurance information
CPT code support means the code may be compatible with Thrizer’s claim submission workflow. It does not mean the code is covered, clinically appropriate, reimbursable, or accepted by every insurance plan.
Common CPT codes for mental health clinicians
These are some of the most common codes clinicians ask about when using Thrizer.| CPT code | Common use |
|---|---|
| 90791 | Psychiatric diagnostic evaluation |
| 90792 | Psychiatric diagnostic evaluation with medical services |
| 90832 | Individual psychotherapy, typically 30 minutes |
| 90834 | Individual psychotherapy, typically 45 minutes |
| 90837 | Individual psychotherapy, typically 60 minutes |
| 90839 | Psychotherapy for crisis |
| 90840 | Add-on code for additional crisis psychotherapy time |
| 90845 | Psychoanalysis |
| 90846 | Family psychotherapy without client present |
| 90847 | Family or couples psychotherapy with client present |
| 90853 | Group psychotherapy |
| 96130 | Psychological testing evaluation services |
| 96131 | Add-on code for additional psychological testing evaluation time |
| 96132 | Neuropsychological testing evaluation services |
| 96133 | Add-on code for additional neuropsychological testing evaluation time |
| 96136 | Psychological or neuropsychological test administration and scoring |
| 96137 | Add-on code for additional testing administration and scoring time |
| 96138 | Psychological or neuropsychological test administration by technician |
| 96139 | Add-on code for additional technician testing time |
| 99213 | Established patient evaluation and management visit |
| 99214 | Established patient evaluation and management visit |
| 99215 | Established patient evaluation and management visit |
Add-on and extension codes
Some CPT codes are designed to be used with a primary CPT code. These are often called add-on or extension codes. Thrizer may support a primary CPT code plus add-on or extension units when the additional code represents extra time or additional units for the same underlying service. Examples include:| Primary code | Add-on or extension code | Example use |
|---|---|---|
| 90839 | 90840 | Additional crisis psychotherapy time |
| 96112 | 96113 | Additional developmental testing time |
| 96130 | 96131 | Additional psychological testing evaluation time |
| 96132 | 96133 | Additional neuropsychological testing evaluation time |
| 96136 | 96137 | Additional testing administration and scoring time |
| 96138 | 96139 | Additional technician testing administration time |
| 96202 | 96203 | Additional behavior management training time |
| 97129 | 97130 | Additional therapeutic intervention time |
| 97550 | 97551 | Additional caregiver training time |
| 97810 | 97811 | Additional acupuncture time |
If a session involves more than one CPT code
Thrizer supports one primary CPT code per claim. A claim may include a primary CPT code plus add-on or extension units when those additional units are part of the same underlying service. If the session includes multiple unrelated services, each service should be billed separately. For example, if two codes represent different services rather than additional time for the same service, they may need to be entered as separate charges.Codes that may require review
Some services may require additional review before Thrizer can confirm workflow compatibility. Examples may include:- EMDR intensives
- testing batteries with multiple units
- crisis services with add-on time
- services provided by supervised or associate clinicians
- services outside traditional psychotherapy
- occupational therapy, speech therapy, physical therapy, nutrition, or other pilot workflows
- medical specialist or medication-management workflows
- any CPT code combination where it is unclear whether the second code is an add-on or a separate service
- the CPT code or codes
- the service description
- the session duration
- the clinician license type
- whether the code is intended as the main service or an add-on code
What CPT support does not mean
CPT support in Thrizer means the service may be compatible with Thrizer’s claim submission workflow. It does not mean:- the CPT code is clinically correct for the service
- the code is covered by the client’s plan
- the claim will be approved
- the client will receive reimbursement
- the amount will apply to deductible
- the insurer will accept a specific CPT code combination
- the service meets medical necessity requirements
What to avoid
Avoid combining unrelated CPT codes into one charge. Avoid using a CPT code only because it appears more likely to reimburse. Avoid treating a successful benefit check as a guarantee that a CPT code will be accepted. Avoid submitting a claim before the service, diagnosis, provider, and charge details are complete.If you can’t find a CPT code
Many CPT codes across psychotherapy, testing, health behavior, evaluation and management, rehabilitation, speech, nutrition, and acupuncture service families may be compatible with Thrizer workflows. If you want to confirm a specific code, contact support with the code, the service description, and the clinician license type. Compatibility with Thrizer’s workflow does not guarantee insurer coverage, claim approval, or reimbursement. For sessions that involve a primary CPT plus an add-on or extension representing additional time of the same underlying service (for example, 90839 with 90840, or 96132 with 96133), the units can typically be included on the same charge. Unrelated services should be billed as separate charges. If you are unsure whether two codes represent the same service or separate services, contact support before charging.Non-CPT services
Some services, such as coaching or other non-medical services, may not be compatible with claim submission workflows. If a service cannot be structured with a supported CPT code, diagnosis code, and standard claim information, it should be processed as Self-Pay. No insurance claim is submitted for Self-Pay.Related articles
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