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CPT Codes for EAP Clients

Learn why there are limited CPT code options for EAP clients.

Updated over a week ago

What is an EAP?

An Employee Assistance Program (EAP) is a health and wellness service paid for by an employer. It is designed to provide assessment, referral, and limited counseling sessions for members and their families.

Which EAPs does Grow Therapy accept?

Grow Therapy accepts EAPs from Cigna, Health Advocate, Humana, and United Health/Optum.

Why are there CPT restrictions for EAPs?

If you have an EAP client, you should only see two options when submitting an invoice under Session Type. The restrictions on CPT codes for EAP clients relate to the structured nature of EAP benefits, which often cover a predetermined number of sessions within specific care categories (see examples below). For payout information, refer to the rates sheet; typically, you'll see the same payout as a regular follow-up session.

Cigna EAP

You will have two options for Cigna EAP clients: Preventive medicine counseling and/or risk factor reduction intervention(s) (99404), or the Client did not show up.

Cigna EAP Options

United EAP

You will have two options for United EAP clients: Psychotherapy, 45 minutes (38-52 minutes) (90834), or the Client did not show up.

United EAP Options
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