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December 2016 Texas Medicaid Provider Procedures Manual

Behavioral Health, Rehabilitation, and Case Management Services Handbook : 6 Physician, Psychologist, and Licensed Psychological Associate (LPA) Providers : 6.4 Outpatient Behavioral Health Services

Outpatient behavioral health services performed by the following providers are benefits to clients of any age who have a diagnosis as outlined below when provided in the office, home, skilled nursing or intermediate care facility, outpatient hospital, extended care facility, or in other locations:
The following procedure codes may be used for psychiatric services:
Psychological and
Neuropsychological Testing
Psychotherapy with evaluation and management (E/M)
90839 and 90840 are noncovered procedure codes. This service is included in the appropriate therapy procedure code and is not reimbursed separately.
Interactive complexity add-on procedure code 90875 is informational only and will not be reimbursed separately from the appropriate psychotherapy procedures code.
Family psychotherapy is defined as therapy that focuses on the dynamics of a family unit where the goal is to strengthen the family’s problem solving and communication skills.
Individual psychotherapy is defined as therapy that focuses on the client but may include others in the session with the goals of treatment focused on the client versus the others in attendance.

Texas Medicaid & Healthcare Partnership
CPT only copyright 2014 American Medical Association. All rights reserved.