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 psychology practices.

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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)	Psychologists and non-prescribing clinicians
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 to 37 minutes
90834	45 minutes	38 to 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 to 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 to 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 to 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 to 365 days)	Check your state Medicaid rules
Commercial	Varies (often 90 to 180 days)	Some allow 365 days; confirm per contract

Always verify the current limit in your payer contract, these are general ranges, not guarantees.

Use this as a starting point, not the final word. CPT codes, payer policies, and telehealth rules change regularly. Confirm current codes, coverage, modifiers, and filing limits with each payer before billing. This reference is general information for behavioral health practices, not coding, legal, or reimbursement advice. CPT® is a registered trademark of the American Medical Association.

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