CPT Code for Interactive Complexity: 90785

When communication difficulties complicate care delivery during a psychotherapy session, this is called “interactive complexity.” 90785, the most common code used for interactive complexity, should always be listed separately and in addition to the code for the primary procedure.

CPT code: 90785

Descriptor: Interactive complexity

Interactive complexity most commonly occurs when other parties are involved (such as clients needing interpreters or language translators, parole officers, or minors with legal guardians) or when equipment is needed to assist with communication during care.

When to use 90785

90785 is an add-on code that is used in conjunction with an appropriate primary CPT code. Keep in mind that 90785 is not a time-based code and should not be used if more time is needed for a session. Instead, it should be used to document increased intensity.

Documentation must describe the specific communication factor (e.g., interpreter needed, high caregiver emotionality) and how it complicated the delivery of the primary service, requiring increased clinical skill/intensity.

90785 can be used to manage:

• Maladaptive communication that complicates delivery of care among participants.
• Caregiver emotions or behaviors that interfere with implementation of the treatment plan.
• Mandated reporting of a sentinel event to a third party.
• The use of play equipment, physical devices, interpreter or translator to overcome communication barriers.

90785 cannot be used for:

• Psychotherapy for crisis codes (90839, 90840)
• Family psychotherapy codes (90846, 90847, 90849)
• E/M (evaluation and management) service where no psychotherapy service is reported
• The sole purpose of translation or interpretation services.