CPT 90837 + ICD-10 F42.2: Mixed obsessional thoughts and acts (OCD)
Psychotherapy, 60 minutes billed with Mixed obsessional thoughts and acts (OCD) — documentation requirements, denial reasons, modifiers, and reimbursement context.
CPT Code
90837
Psychotherapy, 60 minutes
ICD-10 Code
F42.2
Mixed obsessional thoughts and acts (OCD)
Compatibility Notes
Used for ERP-based or ACT-based treatment of OCD. F42.2 is the ICD-10 code covering OCD with both obsessional thoughts and compulsive acts — the most common OCD presentation. ERP (Exposure and Response Prevention) is the gold-standard treatment and is expected to be documented. Some insurers require prior authorization for long-term OCD treatment beyond 20 sessions.
Documentation Required
- ✓Session start and stop times confirming 53+ minutes
- ✓OCD diagnosis with documented obsessions and compulsions meeting DSM-5 criteria
- ✓Y-BOCS or equivalent OCD severity scale score
- ✓ERP hierarchy or ACT-based approach documented in treatment plan
- ✓Time spent on obsessions/compulsions per day documented
- ✓Safety screen (OCD-related intrusive thoughts and suicidal ideation)
Common Denial Reasons
- ✗Notes describe anxiety or rumination without meeting OCD-specific criteria
- ✗No evidence of ERP or another evidence-based OCD modality — payers may deny for lack of medical necessity
- ✗Y-BOCS or equivalent not tracked — payers auditing OCD claims expect outcome measurement
Applicable Modifiers
Reimbursement Notes
OON UCR $130–$210. OCD treatment can be lengthy; payers may require re-authorization every 10–20 sessions. Mental health parity laws protect OCD treatment from disproportionate restrictions compared to medical conditions.
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