HJ Modifier for EAP Billing and Coding [2025 Guide]

HJ Modifier on CMS 1500 Claim

The HJ billing modifier is a H Code HCPCS modifier used in coding claims. This H group of modifiers are used to describe either something about the claim or the credentials of the provider. The HJ modifier is the most commonly used of the HCPCS modifiers in behavioral health claims. HJ Modifier Description The HJ […]

HE Modifier for Mental Health Program Billing [2025 Guide]

HE Modifier on CMS 1500 Claim

The HE modifier is a H Code HCPCS modifier used in coding claims. This H group of modifiers are used to describe something else about the claim beyond the procedure or ICD10 diagnosis code. The most commonly used modifier in this group is HJ used to code Employee Assistance Program (EAP) visits. Insurance companies will […]

HP Modifier: Clinical Psychologist Billing Guide

Billing HP Modifier on CMS 1500 Claim

The HP modifier, like the HO modifier and HN, is a HCPCS modifier used in coding claims. This group of modifiers are used to describe something else about the claim. One more commonly used example is the HJ modifier which is usually used to code Employee Assistance Program (EAP) visits. Insurance companies will request that […]

HN Modifier: Bachelors Degree Billing Guide

HN Modifier on CMS 1500 Claim

The HN modifier, like the HO modifier, is a HCPCS modifier used in coding some claims. These modifiers are different from CPT or procedure codes and are used to describe something else about the claim. One commonly used example is the HJ modifier which is usually used to code Employee Assistance Program (EAP) visits. Modifiers […]

CPT Code 99355: The Definitive Guide

CMS 1500 with CPT Code 99355

PLEASE NOTE:  As of 2023, these codes have been removed by CMS and the AMA.   CPT Code 99355 is a prolonged service CPT code add-on.  99355 cannot be billed alone and must be billed with an appropriate procedure code as well as another prolonged service code, 99354. Add-on Code 99355 fits into a sub-group of […]

CPT Code 99354: The Definitive Guide

CMS 1500 99354 Claim

PLEASE NOTE:  As of 2023, these codes have been removed by CMS and the AMA. CPT Code 99354 is a prolonged service CPT code add-on. It cannot be billed alone and must be billed with an appropriate procedure code. It fits into a sub-group of add-ons from 99354-99359 forming a subgroup of prolonged services codes. […]

Family Therapy Billing CPT Codes: The Definitive Guide

CMS 1500 90847 Claim

CPT Code 90847 is a procedure code for behavioral health claims. 90847 is defined as Family psychotherapy (conjoint therapy) (with the patient present), 50 minutes.. Along with 90846 it falls into a subgroup of family psychotherapy procedure codes. It’s billed by Licensed Clinical Social Workers (LCSW), Licensed Professional Counselors (LPC), Licensed Marriage Family Therapist (LMFT), […]

CPT Code 90846: The Definitive Guide [+2025 Reimbursement Rates]

90846 on CMS 1500 Claim

CPT Code 90846 is a procedure code for licensed behavioral health providers.    90846 is defined as Family psychotherapy (without the patient present), 50 minutes. Along with 90847 it falls into a subgroup of family psychotherapy procedure codes. The procedure code is frequently billed by Licensed Clinical Social Workers (LCSW), Licensed Professional Counselors (LPC), Licensed […]

CPT Code 99404: The Definitive Guide [+2025 Reimbursement Rates]

99404 CMS 1500 Claim

CPT Code 99404 is an oddity in the collection of regularly billed CPT codes.  Cigna created this procedure code to describe EAP sessions taking place through their billing system. CPT Code 99404 Description 99404 is defined as Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual. This isn’t the most descriptive CPT […]