During a psychotherapy session, specific communication factors may arise that make it difficult to deliver a service or administer treatment to a patient. This type of scenario is known as interactive complexity, and there are specific CPT codes that psychologists should use when billing for these sessions.
Interactive complexity is typically present with patients who have third parties—such as parents, guardians, other family members, agencies, court officers, or schools—involved in their care. Difficult communication with discordant or emotional family members and trying to engage with young and verbally undeveloped or impaired patients are examples of the factors that can complicate service delivery.
When this happens, you may use CPT® code 90785, the designated add-on code to report interactive complexity, in conjunction with the appropriate psychotherapy service, to report to insurers about the services you’ve provided. You can pair the add-on code with diagnostic evaluation (90791, 90792) or psychotherapy treatment session (90832, 90833, 90834, 90836, 90837, 90838, 90853).
The guidelines for properly reporting interactive complexity have been revised and the new rules became effective on January 1, 2022. Read on for guidance on how to report interactive complexity and some clinical examples of when it applies.