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Claims Reimbursement Update for Marriage and Family Therapy Providers

March 25, 2016

A claims processing issue has caused claims without a Medicare denial to suspend for Marriage and Family Therapists (MFTs) when billing for individual and group psychotherapy services with the following CPT-4 codes:

CPT-4 Code Description
90832 Psychotherapy, 30 minutes with patient and/or family member
90837 Psychotherapy, 60 minutes with patient and/or family member
90839 Psychotherapy for crisis; first 60 minutes
90840 each additional 30 minutes
90853 Group psychotherapy
99366 Medical team conference with interdisciplinary team of health care professionals, face-to-face with patient and/or family, 30 minutes or more, participation by nonphysician qualified health care professional
99368 Medical team conference with interdisciplinary team of health care professionals, patient and/or family not present, 30 minutes or more; participation by nonphysician qualified health care professional

This issue is currently being addressed. MFT providers do not need a Medicare denial for reimbursement of billed services. Providers are encouraged to refer back to the Medi-Cal website regularly for further updates.