Mental health CPT codes are the foundation of behavioral health reimbursement. Every therapy session, psychiatric evaluation, family therapy visit, and crisis intervention requires a specific Current Procedural Terminology (CPT) code for insurance payment. Selecting the wrong code leads to claim denials, compliance risk, and lost revenue.
This guide provides a complete reference to mental health CPT codes for 2026. You will find time-based coding rules, documentation requirements, Medicare reimbursement rates, and clear guidance for every major behavioral health CPT code. Whether you are a therapist, psychologist, psychiatrist, or billing professional, this reference will help you code more accurately and collect more revenue.
What Are Mental Health CPT Codes?
CPT codes are five-digit numeric codes published annually by the American Medical Association (AMA). They identify the specific clinical services a provider delivers during a patient encounter. Insurance companies, Medicare, and Medicaid use these codes to calculate reimbursement amounts and process claims.
Mental health CPT codes cover the full range of behavioral health services. These include individual psychotherapy, psychiatric diagnostic evaluations, family therapy, group therapy, and crisis intervention. Each code carries documentation requirements, time rules, and reimbursement rates that vary by payer and geographic location.
Behavioral health billing depends on accurate CPT codes more than nearly any other claim element. ICD-10-CM diagnosis codes establish medical necessity. The CPT code identifies the exact service delivered. Together, they determine whether a claim receives timely payment or results in a denial.
How Time-Based Psychotherapy Codes Work
Most individual psychotherapy CPT codes are time-based. The code you select must match the actual documented length of the clinical session. Time-based coding requires the provider to record the exact start time and stop time of every encounter.
The three primary individual psychotherapy time ranges are:
- CPT 90832: For sessions lasting 16 to 37 minutes
- CPT 90834: For sessions lasting 38 to 52 minutes
- CPT 90837: For sessions lasting 53 minutes or more
Sessions under 16 minutes typically do not meet the minimum threshold for a psychotherapy CPT code. Brief contacts at this length are better captured under evaluation and management codes when medically appropriate.
Never round session times up to qualify for a higher-paying code. Billing 90837 for a documented 48-minute session is a coding error and a compliance violation. The selected code must always reflect the actual documented time. Payers audit time-based codes closely
Complete Mental Health CPT Code Reference Table
The following table covers all major mental health CPT codes for 2026. Medicare rates are approximate national averages. Rates vary by geographic location. Verify current rates through the CMS Physician Fee Schedule lookup tool.
| CPT Code | Description | Time Range | Type | Who Qualifies | Avg. Medicare |
|---|---|---|---|---|---|
| 90791 | Psychiatric Diagnostic Evaluation | 60+ min | Primary | All MH providers | ~$162 |
| 90792 | Psychiatric Diagnostic Eval. with Medical Services | 60+ min | Primary | Psychiatrists/prescribers | ~$228 |
| 90785 | Interactive Complexity (Add-On) | N/A | Add-On | All MH providers | +~$21 |
| 90832 | Psychotherapy, 30 Minutes | 16-37 min | Primary | All MH providers | ~$68 |
| 90833 | Psychotherapy Add-On, 30 Min (to E/M) | 16-37 min | Add-On | Psychiatrists only | ~$65 |
| 90834 | Psychotherapy, 45 Minutes | 38-52 min | Primary | All MH providers | ~$100 |
| 90836 | Psychotherapy Add-On, 45 Min (to E/M) | 38-52 min | Add-On | Psychiatrists only | ~$97 |
| 90837 | Psychotherapy, 60 Minutes | 53+ min | Primary | All MH providers | ~$134 |
| 90838 | Psychotherapy Add-On, 60 Min (to E/M) | 53+ min | Add-On | Psychiatrists only | ~$131 |
| 90846 | Family Psychotherapy, Without Patient Present | 50+ min | Primary | All MH providers | ~$100 |
| 90847 | Family Psychotherapy, With Patient Present | 50+ min | Primary | All MH providers | ~$110 |
| 90853 | Group Psychotherapy | 45-90 min | Primary | All MH providers | ~$35/member |
| 90839 | Crisis Psychotherapy, Initial 30-74 Minutes | 30-74 min | Primary | All MH providers | ~$197 |
| 90840 | Crisis Psychotherapy, Each Additional 30 Minutes | +30 min | Add-On | All MH providers | ~$99 |
Diagnostic Evaluation CPT Codes
Diagnostic evaluation codes cover the comprehensive initial assessment of a new patient or a patient presenting with a new clinical concern. These codes represent the starting point for most behavioral health treatment relationships.
CPT 90791: Psychiatric Diagnostic Evaluation
Use CPT 90791 for a psychiatric diagnostic evaluation that does not include medical services. The provider conducts a thorough psychiatric history, evaluates current symptoms and functional status, and develops a diagnostic formulation and treatment plan.
Psychologists, licensed professional counselors (LPCs), licensed clinical social workers (LCSWs), and marriage and family therapists (MFTs) most commonly use 90791 for initial intake appointments. This code reflects comprehensive clinical assessment without prescribing authority or medical decision-making.
Required documentation for 90791: chief complaint and present illness, complete psychiatric history, past treatment history, substance use history, medical and family psychiatric history, a full mental status examination, diagnostic formulation using DSM or ICD criteria, and treatment recommendations with a clear treatment plan. Average Medicare reimbursement: approximately $162.
CPT 90792: Psychiatric Diagnostic Evaluation with Medical Services
Use CPT 90792 when the evaluation includes medical services such as prescribing medications, reviewing laboratory results, or exercising medical decision-making. Psychiatrists and other licensed prescribers primarily bill this code.
Non-physician mental health providers cannot bill CPT 90792 under any circumstances. Billing 90792 as a psychologist or licensed counselor is a compliance violation. Providers must accurately reflect their scope of practice in code selection.
Documentation for 90792 includes all elements of 90791 plus evidence of medical evaluation, medication review, prescribing rationale, and documentation of medical decision-making. Average Medicare reimbursement: approximately $228.
Individual Psychotherapy CPT Codes (90832, 90834, and 90837)
Individual psychotherapy codes cover one-on-one therapy sessions between a provider and their patient. Time documentation is essential for these codes. Document the exact start and stop times in every clinical note.
CPT 90832: Psychotherapy, 30 Minutes (16-37 Minute Sessions)
Bill CPT 90832 for individual psychotherapy sessions lasting between 16 and 37 minutes. This is the shortest billed psychotherapy session. Use 90832 for brief check-in sessions, crisis follow-up contacts that do not meet crisis code thresholds, or when session length is shortened due to patient factors.
Do not assume that short sessions require 90832 automatically. Always verify the documented time before selecting this code. If the session reached 38 minutes, 90834 is the appropriate code. Average Medicare reimbursement: approximately $68.
CPT 90834: Psychotherapy, 45 Minutes (38-52 Minute Sessions)
Bill CPT 90834 for sessions lasting between 38 and 52 minutes. This is the most commonly billed individual psychotherapy code. It reflects the standard 45-to-50-minute therapy session used by the majority of outpatient behavioral health providers.
Because 90834 covers the widest real-world session range, it is also the code most frequently miscoded. Providers sometimes bill 90837 for sessions that never reached 53 minutes. Always confirm the documented time before upgrading to 90837. Average Medicare reimbursement: approximately $100.
CPT 90837: Psychotherapy, 60 Minutes (53+ Minute Sessions)
Bill CPT 90837 when the documented session time is 53 minutes or longer. This code carries the highest reimbursement among standard individual psychotherapy codes. The clinical note must clearly document that the session lasted at least 53 minutes.
A 52-minute session billed as 90837 is a coding error. A 53-minute session billed as 90834 represents lost revenue. The documented time is the determining factor. Providers who consistently deliver 53-minute or longer sessions should use 90837 routinely, with documentation to support it. Average Medicare reimbursement: approximately $134.
Psychotherapy Add-On Codes: 90833, 90836, and 90838
Three add-on codes are available exclusively for psychiatrists and prescribing providers who deliver both medication management and psychotherapy in the same session. These codes cannot stand alone. They must be billed alongside an Evaluation and Management (E/M) code.
The psychotherapy add-on codes follow the same time rules as the primary psychotherapy codes:
- CPT 90833: 16-37 minutes of psychotherapy added to an E/M service (average Medicare: ~$65)
- CPT 90836: 38-52 minutes of psychotherapy added to an E/M service (average Medicare: ~$97)
- CPT 90838: 53+ minutes of psychotherapy added to an E/M service (average Medicare: ~$131)
Important billing rules for add-on psychotherapy codes:
- Never bill a primary psychotherapy code (90832/90834/90837) AND a psychotherapy add-on code (90833/90836/90838) for the same patient on the same date of service.
- Both the E/M component and the psychotherapy component must be documented separately and distinctly in the clinical note.
- The E/M note must stand independently. The psychotherapy portion must reflect its own clinical content beyond the E/M documentation.
- Only providers authorized to deliver both E/M services and psychotherapy can use these add-on codes. Therapists and psychologists cannot bill 90833, 90836, or 90838.
Many psychiatrists are not billing these add-on codes at all. When a psychiatrist provides medication management and meaningful psychotherapy in the same session, the add-on code is appropriate and the revenue is recoverable.
The Interactive Complexity Add-On: CPT 90785
CPT 90785 is an add-on code that captures additional clinical complexity during a psychotherapy session. Many behavioral health providers overlook this code, leaving legitimate reimbursement uncollected.
CPT 90785 can be added to individual psychotherapy codes (90832, 90834, 90837), family therapy codes (90846, 90847), group therapy (90853), and psychotherapy add-on codes (90833, 90836, 90838). It cannot be billed with diagnostic evaluation codes (90791 or 90792).
Four specific conditions qualify a session for CPT 90785. At least one must be present and clearly documented:
- Third-party involvement is required for treatment: The session requires active coordination with a guardian, parent, school official, court officer, or other third party on behalf of the patient.
- The patient uses maladaptive communication: This includes physically aggressive behavior during the session, non-verbal communication that complicates treatment, or self-injurious behavior requiring management.
- Evidence-based treatment was modified for a complex patient: The provider adapted a standard therapeutic protocol due to co-occurring psychiatric diagnoses or complex clinical factors.
- Care coordination is required across multiple providers or systems: The patient’s care involves active coordination between mental health, medical, legal, or educational systems, requiring the provider’s direct management.
When one of these conditions is present, the documentation must explicitly identify which qualifying factor applies. Average Medicare reimbursement for 90785: approximately $21 added to the base code.
Family Psychotherapy CPT Codes: 90846 and 90847
Family psychotherapy codes cover sessions that focus on the identified patient’s relationships with family members, caregivers, or their primary support system.
CPT 90846: Family Psychotherapy Without Patient Present
Use CPT 90846 when the therapist meets with family members or caregivers only, without the identified patient present. The focus of the session is on caregiver education, family communication patterns, treatment coordination, or strategies to support the patient’s recovery.
Documentation must identify who attended the session by name, the clinical focus, and the relevance to the patient’s overall treatment plan. Session length must be 50 minutes or more. Average Medicare reimbursement: approximately $100.
CPT 90847: Family Psychotherapy With Patient Present
Use CPT 90847 when the identified patient and family members or caregivers participate together in the session. The clinical note must document who was present, the nature of the relational dynamics addressed, and the patient’s active participation.
CPT 90847 reimburses slightly higher than 90846, reflecting the clinical complexity of including the patient in family work. Session length must be 50 minutes or more. Average Medicare reimbursement: approximately $110.
Group Psychotherapy: CPT 90853
CPT 90853 covers group psychotherapy sessions with two or more patients treated simultaneously by one provider. Unlike individual psychotherapy codes, 90853 is not time-based. However, standard group sessions typically run between 45 and 90 minutes.
Key billing rules for CPT 90853 that many providers misunderstand:
- Bill 90853 once per patient per session, not once for the entire group.
- Each group member receives their own claim for each group session they attend.
- Documentation must include an attendance list naming every group member present at each session.
- Individual clinical observations for each group member must appear in the session note.
- The clinical note must describe the group focus and each member’s participation level.
A group of eight patients generates eight separate claims for the same session. At approximately $35 per member under Medicare, a single group session produces $280 in potential revenue. Commercial payer rates are often higher than Medicare rates for group therapy.
Average Medicare reimbursement per member: approximately $35. Average commercial payer rate per member: $50-$90.
Crisis Intervention CPT Codes: 90839 and 90840
Two CPT codes cover psychiatric crisis psychotherapy services for patients experiencing acute behavioral health emergencies. These codes are distinct from standard outpatient psychotherapy and have different documentation requirements.
CPT 90839: Crisis Psychotherapy, Initial 30-74 Minutes
Bill CPT 90839 for the first 30-74 minutes of crisis intervention for a patient in psychiatric crisis. The service involves urgent assessment, safety evaluation, and active therapeutic intervention. The provider must be physically present or available via telehealth during the crisis encounter.
CPT 90839 has a minimum time threshold of 30 minutes. A crisis contact lasting less than 30 minutes does not qualify for this code. The maximum time range for a single unit of 90839 is 74 minutes. Sessions that exceed 74 minutes should add CPT 90840. Average Medicare reimbursement: approximately $197.
CPT 90840: Crisis Psychotherapy, Each Additional 30 Minutes
Bill CPT 90840 as an add-on for each additional 30-minute block of crisis service beyond the 90839 threshold. For example, a 90-minute crisis session would bill one unit of 90839 plus one unit of 90840. A 120-minute session would bill 90839 plus two units of 90840.
Documentation for 90839 and 90840 must include: the nature and severity of the psychiatric crisis, clinical interventions used during the encounter, the patient’s response to those interventions, a formal risk assessment, the safety plan developed, and the disposition (hospitalization, outpatient follow-up, family notification, etc.). Average Medicare reimbursement per add-on unit: approximately $99.
Telehealth Mental Health CPT Codes and Modifiers
Telehealth mental health services use the same CPT codes as in-person services. The key differences are the place of service (POS) code and the telehealth modifier. Both must be accurate for the claim to process correctly.
Place of Service Codes for Mental Health Telehealth
- POS 02: Patient is located at a qualifying healthcare facility serving as an originating site. Less common for mental health telehealth in 2025.
- POS 10: Patient is at home or at a non-healthcare location such as their residence or office. This is the most common telehealth POS for outpatient mental health services.
Telehealth Modifiers
- Modifier 95: Synchronous real-time telehealth via audio and video connection. This is the standard modifier for most mental health telehealth visits.
- Modifier GT: Synchronous telehealth via interactive audio and video. Required by some payers and used in certain Medicare Part B scenarios.
- Modifier GQ: Asynchronous store-and-forward telehealth. Rarely applicable to mental health services, which are typically delivered synchronously.
Most outpatient mental health telehealth visits use POS 10 with modifier 95. Always confirm modifier requirements with each specific payer before submitting telehealth claims. Payer telehealth policies vary considerably. Some commercial payers reimburse telehealth at the same rate as in-person visits. Others apply a fee reduction. Verify each payer’s policy separately.
E/M CPT Codes for Psychiatrists: Medication Management
Psychiatrists who provide medication management without psychotherapy bill using Evaluation and Management (E/M) codes. Since 2021, E/M codes use a medical decision-making complexity model rather than the old documentation-element counting system.
The table below shows common E/M codes used in psychiatric medication management with approximate Medicare rates and examples of add-on code combinations.
| E/M Code | Patient Type | Complexity Level | Avg Medicare | With Add-On Example |
|---|---|---|---|---|
| 99202 | New | Straightforward complexity | ~$96 | 99202 + 90833 = ~$161 |
| 99203 | New | Low complexity | ~$137 | 99203 + 90833 = ~$202 |
| 99204 | New | Moderate complexity | ~$185 | 99204 + 90836 = ~$282 |
| 99205 | New | High complexity | ~$233 | 99205 + 90838 = ~$364 |
| 99212 | Established | Low complexity | ~$55 | 99212 + 90833 = ~$120 |
| 99213 | Established | Low to moderate complexity | ~$112 | 99213 + 90833 = ~$177 |
| 99214 | Established | Moderate complexity | ~$165 | 99214 + 90836 = ~$262 |
| 99215 | Established | High complexity | ~$219 | 99215 + 90838 = ~$350 |
Psychological Testing CPT Codes
Psychologists who conduct formal psychological or neuropsychological testing use a separate set of CPT codes. These codes differ from standard psychotherapy and evaluation codes.
- CPT 96130: Psychological testing evaluation by a psychologist, first hour. Average Medicare: ~$200.
- CPT 96131: Psychological testing evaluation, each additional hour. Average Medicare: ~$99 per hour.
- CPT 96132: Neuropsychological testing evaluation, first hour. Average Medicare: ~$218.
- CPT 96133: Neuropsychological testing evaluation, each additional hour. Average Medicare: ~$107.
- CPT 96136: Psychological or neuropsychological test administration and scoring, first 30 minutes. Average Medicare: ~$54.
- CPT 96137: Test administration and scoring, each additional 30 minutes. Average Medicare: ~$27.
Documentation must specify the tests administered, the clinical purpose of the evaluation, the time spent on each service component, and the findings and recommendations from the testing.
Documentation Requirements by CPT Code
The following table summarizes the key documentation requirements for each CPT code category. Meeting these requirements is essential for claim approval and compliance with payer audits.
| CPT Code(s) | Required Documentation Elements |
|---|---|
| 90791 | Chief complaint, comprehensive psychiatric history, past treatment, substance use, medical and family history, mental status examination, diagnostic formulation, treatment plan |
| 90792 | All elements of 90791 PLUS medical evaluation, medication review, prescribing rationale, and documentation of medical decision-making |
| 90832 / 90834 / 90837 | Exact start and stop time, session focus, clinical interventions used, patient response, progress toward treatment goals, plan for next session |
| 90833 / 90836 / 90838 | Complete E/M documentation (history, MSE, assessment, plan) PLUS psychotherapy documentation with exact time, both components documented separately |
| 90785 | Specific qualifying factor documented: (1) third-party involvement, (2) maladaptive communication, (3) modified evidence-based treatment, or (4) complex care coordination |
| 90846 / 90847 | Attendees identified by name, family system focus, nature of dynamics addressed, patient participation status, implications for treatment plan |
| 90853 | Group attendance list (all members named), session focus, individual observations for each attending member, progress notes per patient |
| 90839 / 90840 | Nature and severity of the crisis, clinical interventions provided, patient response to intervention, risk assessment, safety plan, disposition and follow-up plan |
Common Mental Health CPT Coding Errors
Coding errors reduce practice revenue and create compliance exposure. The following errors are the most frequently identified in mental health billing audits. Addressing each one directly improves collection rates and reduces denial risk.
- Billing 90837 for sessions under 53 minutes: The documentation must support at least 53 minutes. A documented 50-minute session billed as 90837 is a coding error that can trigger an audit.
- Combining primary and add-on psychotherapy codes on the same date: Billing 90834 and 90836 on the same day for the same patient is not allowed. Use either a primary code OR the add-on, not both.
- Non-prescribers billing CPT 90792: Psychologists, counselors, and therapists cannot bill 90792. This code is restricted to providers who deliver medical services.
- Missing exact session times in clinical notes: “Approximately 50 minutes” is not sufficient. The note must state a specific start time and stop time to support time-based codes.
- Overlooking CPT 90785 when a qualifying condition is present: Providers who meet one of the four qualifying criteria should bill 90785 consistently. Missing this add-on leaves reimbursement uncollected.
- Not using crisis codes when crisis services are provided: Providers who deliver crisis intervention often bill standard psychotherapy codes instead of 90839. The higher-reimbursing crisis codes are appropriate and should be used when the clinical threshold is met.
- Incorrect telehealth modifier or wrong POS code: Using the wrong modifier or place of service code for telehealth visits results in claim denials. Verify both elements for every telehealth claim.
- Billing group therapy once per group instead of per patient: Group therapy must be billed separately for each patient who attends. Billing once for the whole group results in significant undercollection.
- Selecting E/M complexity level without supporting documentation: The E/M code must match the documented complexity. Billing 99215 (high complexity) requires clinical documentation that clearly supports high complexity. Underdocumentation is a common audit finding.
- Using deleted or outdated CPT codes: The AMA removes and revises codes annually. Submitting claims with deleted codes results in automatic rejection. Update your code library every January.
How to Choose the Right Mental Health CPT Code
Use this step-by-step process to select the correct CPT code for every clinical encounter.
- Identify the service type: Is this a diagnostic evaluation, individual therapy, family therapy, group therapy, or crisis intervention?
- Determine who is present: Patient only? Family with patient? Family without patient? Multiple patients in a group?
- Check the documented session time: For time-based codes, confirm the exact start and stop time. Match the time to the appropriate code range.
- Assess for interactive complexity: Is a qualifying factor (third-party involvement, maladaptive communication, modified evidence-based treatment, complex coordination) documented? If yes, add CPT 90785.
- Determine if E/M services were provided: For psychiatrists, did the session include medication management or medical decision-making? If yes, select the appropriate E/M code and the psychotherapy add-on.
- Confirm telehealth delivery: Was the session delivered remotely? If yes, confirm the correct POS code (02 or 10) and modifier (95 or GT) for the specific payer.
- Verify documentation supports the selected code: Before submitting, confirm that the clinical note meets all documentation requirements for the code you have chosen.
CPT Code Updates and Changes for 2026
The AMA releases updated CPT codes each January. Providers must update their billing systems and code lists annually. Using deleted codes results in automatic claim rejection. Missing new codes means forfeiting legitimate revenue.
Key areas of change for 2025-2026 include:
- Behavioral health integration codes: CPT codes 99484, 99492, 99493, and 99494 support collaborative care models where behavioral health consultants work alongside primary care providers. These codes are growing in use as integrated care models expand nationally.
- Telehealth policy updates: CMS and commercial payers continue to refine telehealth coverage policies. POS codes and modifier requirements may be updated. Always verify current payer requirements at the start of each new year.
- E/M code documentation guidance: The AMA and CMS continue to refine documentation guidance for E/M codes used in psychiatric settings. Stay current through AMA resources and payer newsletters.
- New or revised add-on codes: Review the AMA CPT codebook each January for any new add-on codes that may apply to behavioral health services. New add-ons represent billing opportunities that competitors may miss.
HS MED Solutions monitors all CPT code changes and updates client billing configurations at the start of each new year. Providers who partner with HS MED Solutions do not need to track these changes independently.
How HS MED Solutions Ensures Accurate CPT Coding
HS MED Solutions maintains a dedicated coding team with deep expertise in behavioral health CPT codes. Our team stays current on AMA CPT updates, payer-specific coding requirements, and documentation standards for every major mental health code.
Our CPT coding quality assurance process includes:
- Pre-submission claim scrubbing to catch coding errors before payer submission
- Regular payer policy monitoring to verify modifier and place of service accuracy
- Time-based coding verification using documented session times from provider notes
- Interactive complexity review to identify and bill CPT 90785 when qualifying conditions are present
- Add-on code auditing for psychiatrists to ensure 90833, 90836, and 90838 are billed when appropriate
- Denial pattern analysis to identify and correct recurring coding errors across the practice
- Annual code update implementation every January for all client billing profiles
Providers who partner with HS MED Solutions for mental health billing never need to wonder which code to use or whether their documentation supports it. Our team handles all coding decisions based on the clinical documentation provided and the payer requirements in effect.
We serve psychiatrists, psychologists, therapists, counselors, group practices, and behavioral health clinics across all 50 states. Contact HS MED Solutions today to learn how our mental health billing solutions can improve your coding accuracy and increase your collections.
Conclusion
Mental health CPT codes are complex, but they are learnable. The key is understanding the rules that govern each code: time ranges for psychotherapy codes, scope-of-practice restrictions for diagnostic evaluation codes, add-on code combinations for psychiatrists, and documentation requirements for every service type.
For 2026, the most important coding priorities for behavioral health providers are: accurate time documentation for 90832, 90834, and 90837; consistent use of the interactive complexity add-on 90785 when qualifying factors are present; correct telehealth modifier and POS code selection; and annual review of CPT code updates in January.
HS MED Solutions specializes in mental health billing and CPT coding for behavioral health practices across the United States. Our 25+ years of revenue cycle management experience means your coding is in expert hands. Partner with us to reduce denials, improve accuracy, and maximize your collections.
Frequently Asked Questions
Mental health CPT codes are five-digit codes from the AMA that identify the clinical services provided during behavioral health encounters. Insurance companies use these codes to calculate reimbursement for services including psychotherapy, psychiatric evaluations, family therapy, group therapy, and crisis intervention.
CPT 90834 covers sessions lasting 38-52 minutes. CPT 90837 covers sessions lasting 53 minutes or more. The choosing factor is the documented session time. Bill 90837 only when your clinical note confirms the session lasted at least 53 minutes. Billing 90837 for a 50-minute session is a coding error.
Only psychiatrists and other licensed prescribing providers can bill CPT 90792. This code covers psychiatric diagnostic evaluations that include medical services such as prescribing, reviewing labs, or making medical decisions. Psychologists, counselors, and therapists cannot bill 90792 in most states.
CPT 90785 is an interactive complexity add-on code. Bill it when one of four qualifying conditions is present: a third party must be involved in treatment, the patient uses maladaptive communication during the session, evidence-based treatment was modified for a complex patient, or complex care coordination across multiple systems is required. Document the specific qualifying factor clearly.
Bill CPT 90853 separately for each patient who attends the group session. Do not bill 90853 once for the entire group. Each attending member generates their own claim. Documentation must include an attendance list, group session focus, and individual clinical observations for each member.
No. CPT 90837 is a primary individual psychotherapy code. CPT 90833 is a psychotherapy add-on billed alongside an E/M code. You cannot bill a primary psychotherapy code and a psychotherapy add-on code for the same patient on the same date. Use one or the other, depending on whether E/M services were provided in the same session.
Telehealth mental health sessions use the same CPT codes as in-person sessions (90832, 90834, 90837, etc.). Add POS code 10 if the patient is at home or a non-healthcare location, or POS 02 if the patient is at a healthcare facility. Add modifier 95 for synchronous audio-video telehealth. Some payers require modifier GT instead.
CPT 90839 covers the first 30-74 minutes of crisis psychotherapy. CPT 90840 is an add-on for each additional 30 minutes of crisis service. Documentation must include crisis nature, interventions, patient response, risk assessment, safety plan, and disposition. Average Medicare rate: ~$197 for 90839 and ~$99 per unit of 90840.
All psychotherapy CPT codes require documentation of: exact session start and stop time, session focus and therapeutic interventions used, patient response to interventions, progress toward treatment goals, and a plan for the next session. Time-based codes (90832/90834/90837) must include the specific time to justify the code selected.
Medicare reimburses approximately $134 for CPT 90837 (individual psychotherapy, 60 minutes) based on 2025 national averages. Rates vary by geographic location and payment locality. Commercial payer rates typically range from $100 to $220 per session, depending on the plan and negotiated fee schedule.
Psychiatrists use E/M codes for medication management: 99213, 99214, or 99215 for established patients and 99203, 99204, or 99205 for new patients. When psychotherapy is provided in the same session, they add 90833 (30 min), 90836 (45 min), or 90838 (60 min) to the E/M code. Both services must be documented separately.
The AMA updates the CPT code set every January. Changes include new codes, revised code descriptions, and deleted codes. Providers should review their CPT code lists and billing system configurations at the start of each new year. Billing a deleted code results in automatic rejection. Missing a new code means forfeiting legitimate revenue.
