HMSA recognizes the following service codes for the reporting of psychiatric and psychological services. (See Code Books for information on how to obtain the books.)
Effective date for the following CPT codes: 01/01/2019
| CPT Code | Footnote(s) | Description |
|---|---|---|
| 90791 | 1 | Psychiatric diagnostic evaluation |
| 90792 | 1,3 | Psychiatric diagnostic evaluation with medical services |
| 90832 | 2 | Psychotherapy, 30 minutes with patient |
| 90833 | 2,3 | Psychotherapy, 30 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure) |
| 90834 | 4 | Psychotherapy, 45 minutes with patient |
| 90836 | 3,4 | Psychotherapy, 45 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure) |
| 90837 | 6 | Psychotherapy, 60 minutes with patient |
| 90838 | 3,6 | Psychotherapy, 60 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure) |
| 90839 | 6 | Psychotherapy for crisis; first 60 minutes |
| 90840 | 2 | each additional 30 minutes (List separately in addition to code for primary procedure) |
| 90846 | 4 | Family psychotherapy (without the patient present), 50 minutes |
| 90847 | 4 | Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes |
| 90849 | 4 | Multiple-family group psychotherapy |
| 90853 | 4 | Group psychotherapy (other than of a multiple-family group) |
| 90870 | 1, 5 | Electroconvulsive therapy (includes necessary monitoring) |
| 96130 | 1 | Psychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, family member(s) or caregiver(s), when performed; first hour |
| 96131 | 1 | Psychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, family member(s) or caregiver(s), when performed; each additional hour (List separately in addition to code for primary procedure) |
| 96132 | Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, family member(s) or caregiver(s), when performed; first hour | |
| 96133 | Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, family member(s) or caregiver(s), when performed; each additional hour (List separately in addition to code for primary procedure) | |
| 96136 | Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; first 30 minutes | |
| 96137 | Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; each additional 30 minutes (List separately in addition to code for primary procedure) | |
| 96138 | Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; first 30 minutes | |
| 96139 | Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; each additional 30 minutes (List separately in addition to code for primary procedure) | |
| 96146 | Psychological or neuropsychological test administration, with single automated, standardized instrument via electronic platform, with automated result only |
Procedure Codes for HMSA's Plan for QUEST Members
HMSA recognizes the following additional service codes for the reporting of psychiatric and psychological services for HMSA's Plan for QUEST Members.
| Code | Description |
|---|---|
| H0007‑52 | BHMC Plan crisis intervention, contact by telephone; SMI/SED only; one to three hours total time |
| H0007 | BHMC Plan crisis intervention; telephone contact, followed by face-to-face contact; SMI/SED only; one to three hours total time |
| H0023-52 | BHMC Plan outreach attempt, no patient contact made; per 15 minutes; SMI/SED only |
| H0023 | BHMC Plan outreach contact; per 15 minutes; SMI/SED only |
| H0036 | BHMC Plan biopsychosocial rehabilitation, social skills; individual or group; minimum of 30 minutes per 15 minutes; SMI/SED only |
| H0036-52 | BHMC Plan biopsychosocial rehabilitation, social recreation, group for 15 minutes; SMI/SED only |
| T1017 | Clozaril (Clozapine) - case management only - includes blood draw, wBC tests and monitoring related to clozaril; drug not included |
| H2001-52 | BHMC plan pre-vocational rehabilitation individual or group; per 15 minutes; SMI/SED only |
| H0020 | Methadone treatment (only for short visit, not counseling) |
| 90832-HE | Psychiatric clinic group therapy by non-psychologist (DOH clinics only) |
| 90853-HE | Psychiatric clinic visit (DOH clinics only) |
| 90791-SE | DHS 1271 Evaluation |
| 90792-SE | DHS 1271 Evaluation with medical services |
| 90791-52 | DHS 1271 Re-evaluation |
| 90792-52 | DHS 1271 Re-evaluation with medical services |
| 90791‑HA | Child behavioral health evaluation for eligibility in the Felix vs. Waihee class, by psychologist |
| T1017-22 | Case assessment (only for DOH, target care management) |
| T1017-51 | Case planning (only for DOH, target care management) |
| T1017 | Ongoing monitoring and service coordination (only for DOH, target care management) |
| T1013 | QUEST enabling service, foreign language translation, per 15 minutes |
| H0023-22 | QUEST enabling service, non-compliance counseling, per 15 minutes |
| T2003 | QUEST enabling service, ground transportation, per mile (restricted to accessing needed health care services, and provided when no other appropriate means of transportation is available) |
- Counts as one hour (visit) toward the patient's maximum number of visits (hours), regardless of the amount of time expended on a single day.
- Counts as 1/2 hour toward the patient's maximum number of visits (hours).
- This code may only be billed by a psychiatrist (M.D.) or advanced practice registered nurse (APRN).
- Counts as one hour toward the patient's maximum number of visits (hours).
- This code may only be billed by a psychiatrist (M.D.).
- Counts as 1.5 hours toward the patient's maximum number of visits (hours).
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform |