. "4 Strengthening the Evidence Base and Quality Improvement Infrastructure." Improving the Quality of Health Care for Mental and Substance-Use Conditions: Quality Chasm Series. Washington, DC: The National Academies Press, 2006.
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Improving the Quality of Health Care for Mental and Substance-Use Conditions
ment, a significant development, do not yet include codes for measuring the quality of M/SU health care.
CPT codes CPT psychotherapy codes generally do not indicate what specific type of psychotherapy was provided, only that psychotherapy in general was provided and how long the session lasted. The 2005 CPT codes (AMA, 2004a) include only two main codes for psychotherapy:
“Insight Oriented, Behavior Modifying and/or Supportive Psychotherapy” in an office or other outpatient facility, approximately 20 to 30, or 45 to 50, or 75 to 80 minutes face-to-face with the patient (codes 90804, 90806, and 90808 respectively) without or with (codes 90805, 90807, or 90809) accompanying medical evaluation and management services.
“Interactive Psychotherapy” which consists of individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanism of non-verbal communication, in an office or outpatient facility for approximately 20 to 30, or 45 to 50, or 75 to 80 minutes face-to-face with the patient (codes 90810, 90812, and 90814, respectively). These codes are typically used for children or others who have not yet developed or who have lost language communication skills.
A similar number of codes exist for these same services when provided in an inpatient hospital, partial hospital, or residential care facility. Six other codes for psychoanalysis and group, family, and interactive psychotherapy exist, as well as 10 codes for “Other Psychiatric Services or Procedures,” such as electroconvulsive treatments, hypnotherapy, and biofeedback. With the exception of a code for psychoanalysis, none of these codes identify the specific type of psychotherapy administered (e.g., cognitive therapy, behavior modification, cognitive behavioral therapy, interpersonal therapy, dialectical behavioral therapy, prolonged exposure therapy for individuals suffering from posttraumatic stress disorder, Gestalt therapy, movement/dance/art therapy, humanistic therapy, existential therapy, eye movement desensitization therapy, primal therapy, person-centered therapy, multisystemic therapy, and the many variants of these. Nor are there procedure codes for the use of diagnostic or behavioral assessment instruments. Other evidence-based psychotherapies, as well as psychosocial interventions such as family psychoeducation, multisystemic therapy, illness self-management programs, and assertive community treatment also do not have designated CPT codes. Moreover, a recent initiative of the AMA and the CPT Editorial Panel to develop codes for performance measurement (CPT II codes) and emerging technologies, services, and procedures (CPT III codes) has not yet adequately addressed M/SU health care.