Billing / Billing Codes

Clinical social workers who seek independent reimbursement use Current Procedural Terminology (CPT) codes to identify procedures they perform when providing psychotherapy services. The Health Insurance Portability and Accountability Act (HIPAA) has designated CPT as the national coding standard for reporting procedures for health care professionals such as clinical social workers.

The International Classification of Diseases, 10th Edition, Clinical Modification, known as the ICD-10-CM, will be implemented on October 1, 2015.  Clinical social workers are one of many health care professionals who will be required to use the ICD-10-CM coding system when identifying mental health disorders. The ICD 9-CM coding system will not be available for use for services provided on and after October 1, 2015.

Beginning October 1, 2015, clinical social workers and other health care providers, insurance companies, clearinghouses, and others in the health industry will transition from the International Classification of Diseases, 9th Edition, Clinical Modification (ICD-9-CM) to the International Classification of Diseases, 10th Edition, Clinical Modification (ICD-10-CM). The ICD-10-CM is a diagnostic classification system used to identify diseases. Clinical social workers who diagnose and treat mental illness will be required to use the ICD-10-CM when diagnosing patients and submitting paper or electronic claims for reimbursement.

Clinical social workers should begin preparing for the implementation of the International Classification of Diseases, 10th Edition, Clinical Modification, known as the ICD-10-CM. It is a diagnostic classification system used to identify diseases. Developed by the Centers for Disease Control and Prevention for use in all United States health care settings, it is maintained and distributed by the U.S. Department of Health and Human Services (HHS).

There are several major national changes affecting the clinical practice of clinical social workers in 2014.  Clinical social workers should prepare for these changes to avoid reimbursement denials and overpayment requests.

Frequently Asked Questions about the new Psychotherapy Codes.