• Frequently Asked Questions about CPT Codes
• CPT Training Module  (last updated September, 2007)
• CPT Codes Glossary

CPT Codes describe medical or psychiatric procedures performed by physicians and other health providers. The codes were developed by the CMS to assist in the assignment of reimbursement amounts to providers by Medicare carriers. A growing number of managed care and other insurance companies, however, base their reimbursements on the values established by CMS.

Since the early 1970s, CMS has asked the American Medical Association (AMA) to work with physicians of every specialty to determine appropriate definitions for the codes and to try to determine accurate reimbursement amounts for each code. Two committees within AMA work on these issues: the CPT Committee, which updates the definitions of the codes, and the RUC (Relative Value Update Committee), which recommends reimbursement values to CMS based on data collected by medical societies on the going rate of services described in the codes.

David Berland, M.D. and Sherry Barron-Seabrook represent the views of Academy members to these committees and to CMS directly. In the autumn of 1997, for example, the AACAP polled more that 400 Academy members for opinions on the relative values of the 24 new codes (G-codes) that CMS instituted on January 1, 1997. Also in 2002 the AACAP membership was surveyed regarding PEAC expenses. The unique expenses of performing interactive psychotherapy (for example, play therapy with a young child) and of working with parents and siblings of patients have been described to CMS on several occasions, to obtain larger reimbursement amounts for these services.

Academy Resources on CPT Codes

The AACAP has made a number of resources available to members. The CPT Training Module, updated yearly, is designed to help Academy members understand how to use CPT Codes and to provide new information on the many changes to the codes that are instituted each year. The 2006 Module is available for download. (Download CPT Module).

Happy Coding!

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