CMS-1500 Insurance Billing & Superbill Manual

1. Healthcare Provider Taxonomy & Credentialing

Clinical hypnotherapy is officially designated under NUCC Taxonomy Code 101YA0400X (Behavioral Health & Social Service, Clinical Hypnotherapist). All electronic claims submitted via EDI 837P or CMS-1500 paper forms must clearly display Box 24j with NPI 1942859182 and taxonomy code 101YA0400X.

2. Approved CPT Codes for Hypnotherapeutic Intervention

• 90834: Psychotherapy / Clinical Hypnotherapy, 45 minutes with client.
• 90837: Psychotherapy / Clinical Hypnotherapy, 60 minutes with client.
• 90838: Add-on psychotherapy / hypnotherapy when performed with evaluation & management service.
• 90880: Hypnotherapy as a designated therapeutic modality.

3. Diagnostic ICD-10 Cross-Walk

Common insurance-covered diagnostic categories include: F41.1 (Generalized Anxiety Disorder), F43.10 (Post-Traumatic Stress Disorder), F51.01 (Primary Insomnia), G89.4 (Chronic Pain Syndrome), and F17.200 (Nicotine Dependence).

4. Superbill Generation for Client Direct Reimbursement

For out-of-network payers (Cigna, Optum, Aetna), clinicians issue an itemized Superbill including client demographics, diagnosis code, CPT code, paid receipt, and provider NPI. Zen Hypnosis sliding-scale fee assistance is documented under 501(c)(3) guidelines.