Skip to main content

Resource · Billing Codes

Behavioral Health CPT & Billing Code Reference

Most behavioral health claims run on a short list of CPT codes. The evaluation is 90791 or 90792, therapy is 90832, 90834 or 90837 depending on the minutes, and medication management is an office E/M code (99202 to 99215). When a prescriber adds therapy to that visit, it’s the E/M code plus +90833, +90836 or +90838. You’ll also find the crisis, testing and collaborative care codes below, along with telehealth modifiers and each payer type’s filing limit.

Psychiatric Diagnostic Evaluation

Used at intake to establish a diagnosis and a plan of care.

CodeDescriptionNotes
90791Psychiatric diagnostic evaluation (no medical services)Psychologists and non-prescribing clinicians
90792Psychiatric diagnostic evaluation with medical servicesPrescribers (MD/DO, PMHNP, PA)

Individual Psychotherapy (Time-Based)

Choose the code by total face-to-face time. Documenting the actual minutes protects the claim.

CodeSession lengthTime range billed
9083230 minutes16 to 37 minutes
9083445 minutes38 to 52 minutes
9083760 minutes53 minutes or more

Office & Outpatient E/M (Evaluation & Management)

Prescribers bill an office/outpatient E/M code for visits such as medication management. New or established status picks the code range, and the complexity of the visit sets the level.

CodeDescriptionNotes
99202 to 99205Office/outpatient E/M, new patientNew patient: no face-to-face visit with the practice (same specialty/group) in the past 3 years
99211 to 99215Office/outpatient E/M, established patientEstablished 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.

CodeDescriptionNotes
+90833Psychotherapy, 30 min, with E/MAdd-on to an E/M code
+90836Psychotherapy, 45 min, with E/MAdd-on to an E/M code
+90838Psychotherapy, 60 min, with E/MAdd-on to an E/M code

Add-on codes (marked +) are never billed alone. They always go out with a base code.

Family & Group Psychotherapy

CodeDescriptionNotes
90846Family psychotherapy without the patient present~50 minutes
90847Family psychotherapy with the patient present~50 minutes
90853Group psychotherapyPer group member, per session

Crisis Psychotherapy

CodeDescriptionTime
90839Psychotherapy for crisis, first 60 minutes30 to 74 minutes
+90840Crisis psychotherapy, each additional 30 minutesAdd-on to 90839

Add-On & Complexity

CodeDescriptionNotes
+90785Interactive complexityWhen a listed communication factor complicated the session. Not for using an interpreter alone.
+99417 / G2212Prolonged outpatient services, each additional 15 min99417 (most commercial) or G2212 (Medicare), with high-level E/M

Screening, Psychological & Neuropsychological Testing

CodeDescriptionNotes
96127Brief emotional/behavioral assessmente.g., PHQ-9, GAD-7, per standardized instrument
96130 / +96131Psychological testing evaluation (first hour / each additional)By psychologist or physician
96132 / +96133Neuropsychological testing evaluation (first hour / each additional)By psychologist or physician
96136 / +96137Test 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.

CodeDescriptionTime / month
99492Initial psychiatric collaborative care management70 minutes, first month
99493Subsequent psychiatric collaborative care management60 minutes
+99494CoCM, each additional 30 minutesAdd-on
99484General behavioral health integration (BHI)20 minutes

Common Modifiers

ModifierMeaningWhen used
95Synchronous telehealth (audio + video)Real-time video visit
93Audio-only telehealthPermanent for behavioral health; phone-only visits
25Significant, separately identifiable E/ME/M provided with another service the same day
59Distinct procedural serviceTwo 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.

POSMeaningNotes
10Telehealth provided in the patient’s homeTypically pays the higher non-facility rate
02Telehealth provided other than in the patient’s homeTypically pays the facility rate

Audio-only behavioral health is a permanent part of Medicare policy when the patient can’t use video or doesn’t consent to it. Telehealth rules keep changing, including updates effective in 2026, so check each payer’s current coverage and any in-person-visit requirements. Our mental health billing services keep each payer’s current telehealth rule in your billing setup instead of sending every claim out the same way.

Timely Filing Limits By Payer Type

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 typeTypical limitNotes
Medicare12 months from date of serviceCalendar-based
MedicaidVaries by state (often 90 to 365 days)Check your state Medicaid rules
CommercialVaries (often 90 to 180 days)Some allow 365 days; confirm per contract

These are general ranges, not guarantees. Your payer contract sets the actual limit.

Use this as a starting point, not the final word. Codes and telehealth rules change, and each payer’s current policy is what decides the claim, so check it before you bill. 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.

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.

Telehealth Modifiers

Modifier 95 vs. 93, GT, and when POS 10 pays more than POS 02: telehealth billing modifiers for behavioral health.

Want Someone Else Working The Claims?

Picking the right code is the easy part. Money leaks through the add-on sent without its E/M, the home telehealth visit billed with POS 02 at the facility rate, and the provider who isn’t loaded with the payer yet. Our Ongoing Billing service handles claims, denials, posting and A/R follow-up, priced by practice size from 7% of collections for a solo provider down to 4.5% for 26 or more providers, with no setup fee. The monthly minimum is $300 for a solo practice.

The PMHNP CPT Quick Sheet, 2026 Edition

Five pages for the billing desk: the ten codes PMHNPs bill most at a glance, which code fits the visit, the E/M level table, what can be billed together, telehealth and Spravato in 2026, and the questions PMHNPs ask most. We email it to you right away.

We email you the PDF right away, then a short billing or credentialing note now and then. Unsubscribe anytime. Privacy.