American Psychiatric Centers, Inc. d/b/a Comprehensive Psychiatric Services (CPS)
Outcome
American Psychiatric Centers settled for $2.75 million for submitting false claims to federal healthcare programs using psychotherapy add-on CPT codes 90833 and 90836 without the required documentation and justification.
Details
American Psychiatric Centers / Comprehensive Psychiatric Services (Walnut Creek, CA) — Psychotherapy CPT Code Fraud
Outcome: Settled for $2.75 million for submitting false claims to federal healthcare programs using psychotherapy add-on CPT codes 90833 and 90836 without required documentation.
American Psychiatric Centers, Inc., doing business as Comprehensive Psychiatric Services (CPS) in Walnut Creek, California, submitted false claims to government healthcare payers for psychotherapy services using incorrect CPT codes. Specifically, the organization misused "add-on" procedural codes 90833 and 90836 — codes that are only valid when psychotherapy services are performed in conjunction with an evaluation and management (E&M) visit, and which require specific documentation of both the E&M and the psychotherapy components.
CPS allegedly billed these add-on codes without the required concurrent E&M visits and/or without proper documentation to support the codes. This systematic billing of add-on codes without the required underlying service conditions constitutes false claims under the False Claims Act.
The settlement of $2.75 million was announced August 19, 2025, covering violations stretching back to at least 2015.
Primary Source: California Behavioral Medicine Provider Agrees To Pay $2.75 Million To Resolve Alleged False Claims For Psychotherapy Services
How Crucible Prevents This
Crucible's CPT-code compliance hooks would flag add-on psychotherapy codes billed without the required concurrent evaluation and management documentation; a pre-submission audit gate verifying that add-on codes are accompanied by compliant E&M documentation would prevent systematic CPT code abuse.
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