Resource · Billing Codes
Behavioral Health CPT & Billing Code Reference
A practical, plain-language reference to the CPT codes, modifiers, and billing rules behavioral health practices use most — psychotherapy, psychiatric evaluation and medication management, family and group work, crisis, testing, and telehealth. Built for psychiatry, PMHNP, and therapy practices.
Psychiatric diagnostic evaluation
Used at intake to establish a diagnosis and a plan of care.
| Code | Description | Notes |
|---|---|---|
| 90791 | Psychiatric diagnostic evaluation (no medical services) | Therapists, psychologists, social workers, counselors |
| 90792 | Psychiatric diagnostic evaluation with medical services | Prescribers (MD/DO, PMHNP, PA) |
Individual psychotherapy (time-based)
Choose the code by total face-to-face time. Documenting the actual minutes protects the claim.
| Code | Session length | Time range billed |
|---|---|---|
| 90832 | 30 minutes | 16–37 minutes |
| 90834 | 45 minutes | 38–52 minutes |
| 90837 | 60 minutes | 53 minutes or more |
Office & outpatient E/M (evaluation & management)
Prescribers bill an office/outpatient E/M code for visits such as medication management. The level is driven by the patient’s status (new vs. established) and the complexity of the visit.
| Code | Description | Notes |
|---|---|---|
| 99202–99205 | Office/outpatient E/M — new patient | New patient: no face-to-face visit with the practice (same specialty/group) in the past 3 years |
| 99211–99215 | Office/outpatient E/M — established patient | Established patient: seen by the practice within the past 3 years |
Psychotherapy with E/M (add-on codes)
When psychotherapy happens during the same visit as an E/M service, add the matching psychotherapy add-on alongside the E/M code.
| Code | Description | Notes |
|---|---|---|
| +90833 | Psychotherapy, 30 min, with E/M | Add-on to an E/M code |
| +90836 | Psychotherapy, 45 min, with E/M | Add-on to an E/M code |
| +90838 | Psychotherapy, 60 min, with E/M | Add-on to an E/M code |
Add-on codes (marked +) are never billed alone — they always accompany a base code.
Family & group psychotherapy
| Code | Description | Notes |
|---|---|---|
| 90846 | Family psychotherapy without the patient present | ~50 minutes |
| 90847 | Family psychotherapy with the patient present | ~50 minutes |
| 90853 | Group psychotherapy | Per group member, per session |
Crisis psychotherapy
| Code | Description | Time |
|---|---|---|
| 90839 | Psychotherapy for crisis, first 60 minutes | 30–74 minutes |
| +90840 | Crisis psychotherapy, each additional 30 minutes | Add-on to 90839 |
Add-on & complexity
| Code | Description | Notes |
|---|---|---|
| +90785 | Interactive complexity | When communication factors complicate care (third parties, interpreters) |
| +99417 / G2212 | Prolonged outpatient services, each additional 15 min | 99417 (most commercial) or G2212 (Medicare), with high-level E/M |
Screening, psychological & neuropsychological testing
| Code | Description | Notes |
|---|---|---|
| 96127 | Brief emotional/behavioral assessment | e.g., PHQ-9, GAD-7 — per standardized instrument |
| 96130 / +96131 | Psychological testing evaluation (first hour / each additional) | By psychologist or physician |
| 96132 / +96133 | Neuropsychological testing evaluation (first hour / each additional) | By psychologist or physician |
| 96136 / +96137 | Test administration & scoring (first 30 min / each additional) | By a professional |
Collaborative care & behavioral health integration
Used in integrated and primary-care settings where behavioral health is managed alongside medical care.
| Code | Description | Time / month |
|---|---|---|
| 99492 | Initial psychiatric collaborative care management | 70 minutes, first month |
| 99493 | Subsequent psychiatric collaborative care management | 60 minutes |
| +99494 | CoCM, each additional 30 minutes | Add-on |
| 99484 | General behavioral health integration (BHI) | 20 minutes |
Common modifiers
| Modifier | Meaning | When used |
|---|---|---|
| 95 | Synchronous telehealth (audio + video) | Real-time video visit |
| 93 | Audio-only telehealth | Permanent for behavioral health; phone-only visits |
| 25 | Significant, separately identifiable E/M | E/M provided with another service the same day |
| 59 | Distinct procedural service | Two services not normally reported together |
Telehealth place of service
Place of service (POS) tells the payer where the patient was — and it affects the rate.
| POS | Meaning | Notes |
|---|---|---|
| 10 | Telehealth provided in the patient’s home | Typically pays the higher non-facility rate |
| 02 | Telehealth provided other than in the patient’s home | Typically pays the facility rate |
Audio-only behavioral health is a permanent part of Medicare policy when the patient cannot use, or does not consent to, video. Telehealth rules keep changing — including updates effective in 2026 — so confirm current coverage and any in-person-visit requirements with each payer.
Timely filing — know each payer’s clock
Timely filing is the deadline to submit a clean claim from the date of service. Missing it is one of the most avoidable ways to lose revenue, and limits are payer-specific.
| Payer type | Typical limit | Notes |
|---|---|---|
| Medicare | 12 months from date of service | Calendar-based |
| Medicaid | Varies by state (often 90–365 days) | Check your state Medicaid rules |
| Commercial | Varies (often 90–180 days) | Some allow 365 days; confirm per contract |
Always verify the current limit in your payer contract — these are general ranges, not guarantees.
Keep exploring
Behavioral health billing
How these codes get worked: mental health billing and psychiatry & PMHNP billing.
Credentialing & revenue cycle
Codes pay only with credentialing in place and a clean revenue cycle.
Practice operations
Tighten the workflows behind coding with practice operations support.
Losing revenue in the coding and follow-up gaps?
If denials, underpayments, or timely-filing misses keep showing up, the fix is usually upstream of the code. We help behavioral health practices tighten the whole claim cycle.