While precision in how you use CPT codes may not seem of utmost significance, in fact, using the correct CPT codes for the mental health services you provide is important for two major reasons. When your claims include the right codes, they’ll be accepted in a more timely manner, ensuring you have the necessary cash flow to operate your practice. Perhaps more urgently, coding mistakes could cause your practice to be audited, and errors could result in fines. In this post, we’ll cover what you need to know about using CPT codes and the most common codes you should become familiar with.
What are CPT Codes for Mental Health?
The Current Procedural Terminology (CPT) code set describes tests, evaluations, treatments, and other medical procedures used in the spectrum of healthcare. The set contains over 8,000 codes and is published and updated annually by the American Medical Association. It was created to track healthcare trends and issues as well to use in the claims submission process. The codes communicate to payers what procedures you need to be reimbursed for as a provider.
The codes related to mental health (codes 90785-90899) are found in the Psychiatry section of the CPT code set and cover services provided by medical professionals, such as psychiatrists, as well as services that can be delivered by non-medical professionals such as licensed clinical psychologists, licensed professional counselors, licensed marriage and family therapists, and licensed clinical social workers.
Categories of Mental Health CPT Codes
The mental health CPT codes used by therapists are organized into four distinct categories. These categories make it easier to find the code you’re looking for.
Psychiatric Diagnostic Interview
- Code 90801: Psychiatric diagnostic interview examination
- Code 90802: Interactive psychiatric diagnostic interview examination
Psychiatric Therapeutic Services
- Codes 90804-90809: Insight-oriented, behavior modifying and/or supportive psychotherapy
- Codes 90810-90815: Interactive psychotherapy
Family Medical Psychotherapy
- 90846: Family psychotherapy (without the patient present)
- 90847: Family psychotherapy (with the patient present)
- 90849: Multiple-family group psychotherapy
Group Psychotherapy
- 90853: Group psychotherapy (other than a multiple-family group)
- 90857: Interactive group psychotherapy
Common Mental Health CPT Codes
While there are many codes that may be applicable to mental health services more broadly, in a therapy setting, you’ll probably find yourself using only a relatively small subset of these codes. Learning the most common CPT codes for mental health will help you choose the best code for each service you provide. Here are the most common codes that you’ll encounter as a therapist.
90837 — Psychotherapy, 60 minutes
Description: Individual psychotherapy, 60 minutes, with client and/or family member.
Time: 60 minutes (functionally between 53 and 60 minutes)
90834 — Psychotherapy, 45 minutes
Description: Individual psychotherapy, 45 minutes, with client and/or family member.
Time: 45 minutes (functionally between 38 and 52 minutes)
90791 — Psychiatric diagnostic evaluation without medical services
Description: Initial diagnostic interview exam that does not include any medical services. Includes a chief complaint, history of present illness, family and psychosocial history, and complete mental status examination. (Use code 90792 for an initial evaluation with medical services.)
Time: Not time-based
90847 — Family psychotherapy (with client present), 50 minutes
Description: Family psychotherapy (conjoint psychotherapy) (with client present). (Can also be used for couples therapy.)
Time: 50 minutes
90853 — Group psychotherapy (other than of a multiple-family group)
Description: Group psychotherapy (other than of a multiple-family group). Relies on the use of interactions of group members to examine the pathology of each individual within the group. The dynamics of the entire group are noted and used to modify behaviors and attitudes of the client members. (Used to report per-session services for each group member.)
Time: Not time-based
90846 – Family psychotherapy (without client present), 50 minutes
Description: Therapy session intended to aid the treatment of the client, where the family of a client is present without the client being present.
Time: 50 minutes
90875 – Under other psychiatric services or procedures
Description: Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the client), with psychotherapy (e.g., insight-oriented, behavior modifying, or supportive psychotherapy).
Time: 20-30 minutes
90832 – Psychotherapy, 30 minutes
Description: Individual psychotherapy, 30 minutes
Time: 30 minutes (functionally between 16 – 37 mins)
90838 – Psychotherapy, 60 minutes, with E/M service
Description: Individual psychotherapy, 60 minutes with client and/or family member when performed with an evaluation and management (E/M) service.
Time: 60 minutes (functionally between 53 and 60 minutes)
99404 — Under preventive medicine, individual counseling services
Description: Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure)
Time: 60 minutes (functionally between 53 and 60 minutes)
CPT Code Modifiers
Code modifiers provide additional information to a payer. Modifiers can describe the license level of provider, when services were provided, and how the services were provided, among other things. Here are four modifiers that you may encounter.
- Modifier 25 — Typically, a single code will accurately describe a session. But occasionally, you may find that a fully separate E/M service is needed (performed by the same provider) on the same day. Modifier 25 is used in these situations, as it calls out that service as separate and reimbursable. Note that you can only attach modifier 25 to codes 99201-99215, 99341-99350.
- Modifier 59 — Similar to modifier 25, this modifier is used to describe a distinct non-E/M procedural service done on the same day. Note that your documentation must support a separate session.
- Modifier GT — Used for telehealth sessions involving interactive audio and video.
- Modifier UT — Used when the provider sees a patient in crisis.
When you understand how CPT codes work and have a firm knowledge of the codes you’ll use most often in your therapy practice, you’ll increase your claims submission rate and reduce the likelihood of being flagged for inappropriate coding. Beyond the practicality of improving cash flow, accurate coding delivers peace of mind since you won’t have to worry about whether or not you’re using CPT codes correctly.
CPT (Current Procedural Terminology) is a standardized medical codeset maintained by the AMA. CPT codes are five digit numeric codes describing everything from surgery to radiology to psychotherapy.
CPT Codes are different from Diagnosis Codes or ICD10 F-Codes for billing and coding your insurance claims. Here’s our mental health diagnosis code list if you need to look one up.
For therapists that are on managed care panels or provide superbills to their clients, knowing your CPT codes is paramount to getting paid in full and avoiding insurance audits.
The amount insurance companies will reimburse depends on a number of different factors (professional credentials, geographic location, etc.), but using the correct CPT Code and add-on code(s) to express the exact service is an important part to the whole process and in ultimately determining your payment!
Errors, accidental or otherwise, will directly impact insurance company’s payment of services. If you need help with making sure your billing and coding is error-free, our mental health billing service can help.
Think about reaching out if the rest of this article hurts your feelings.
Article Index:
The Most Common Mental Health CPT Codes
The most common CPT Codes used by therapists and behavioral health professionals:
Outpatient Mental Health Therapist Diagnostics, Evaluation, Intake CPT Code:
- 90791 – Psychiatric Diagnostic Evaluation (usually just one/client is covered)
Outpatient Mental Health CPT Codes:
- 90832 – Psychotherapy, 30 minutes (16-37 minutes).
- 90834 – Psychotherapy, 45 minutes (38-52 minutes).
- 90837 – Psychotherapy, 60 minutes (53 minutes and over).
- 90846 – Family or couples psychotherapy, without patient present.
- 90847 – Family or couples psychotherapy, with patient present.
- 90853 – Group Psychotherapy (not family).
- 98968 – Telephone therapy (non-psychiatrist) – limit 3 units/hours per application.
Outpatient Mental Health Crisis CPT Codes:
- 90839 – Psychotherapy for crisis, 60 minutes (30-74 minutes).
- +90840 – Add-on code for an additional 30 minutes (75 minutes and over). Used in conjunction with 90839.
Other Behavioral Health CPT Codes:
- +90785 – Interactive Complexity add-on code. Covered below.
- 90404 – Cigna / MHN EAP CPT Code. These two companies use a unique CPT code for EAP sessions.
- 96101 – Psychological testing, interpretation and reporting by a psychologist (per Hour)
- 90880 – Hypnotherapy – limit 10 units/hours per application
- 90876 – Biofeedback
- 90849 – Multiple family group psychotherapy
- 90845 – Psychoanalysis
Mental Health Add-On CPT Codes
Here is a short list of the most common Add-On codes for routine outpatient mental health billing.
- Add-On CPT Code 90785 – Interactive complexity. Example: play therapy using dolls or other toys. This is an interactive complexity add-on code that is not a payable expense. This code only indicates that the treatment is complex in nature.
- Add-On CPT Code 90863 – Pharmacologic Management after therapy.
- Add-On CPT Code 99050 – Services provided in the office at times other than regularly scheduled office hours, or days when the office is normally closed.
- Add-On CPT Code 99051 – Services provided in the office during regularly scheduled evening, weekend, or holiday office hours.
- Add-On CPT Code 99354 – Additional time after the additional time of 74 minutes. Adding another 30 minutes. (Only use if the duration of your session is at least 90 minutes for 90837 or 80 minutes for 90847).
- Add-On CPT Code 99355 – Additional time after first 60 minutes. First additional 30 to 74 minutes.
- Add-On CPT Code 90840 – 30 additional minutes of psychotherapy for crisis. Used only in conjunction with CPT 90839.
- Add-On CPT Code 90833 – 30 minute psychotherapy add-on. Example: Psychiatrist evaluates medication response, then has 30 minute session.
- Add-On CPT Code 90836 – 45 minute psychotherapy add-on. Example: Clinical Nurse Specialist evaluates medication response, then has 45 minute session.
If you’re wondering how to handle billing add-on codes, we can help make this process simple and automatic. Learn how we can help by inquiring about our billing service.
Outpatient Psychiatry Diagnostics / Evaluation / Client Intake CPT Code:
- 90792 – Psychiatric Diagnostic Evaluation with medical services (usually just one/client is covered)
Outpatient Psychiatry CPT Codes:
- 99201 – E/M – New Patient Office Visit – 10 Minutes
- 99202 – E/M – New Patient Office Visit – 20 Minutes
- 99203 – E/M – New Patient Office Visit – 30 Minutes
- 99204 – E/M – New Patient Office Visit – 45 Minutes
- 99205 – E/M – New Patient Office Visit – 60 Minutes
- 99211 – E/M – Established Patients – 5 Minutes
- 99212 – E/M – Established Patients – 10 Minutes
- 99213 – E/M – Established Patients – 15 Minutes
- 99214 – E/M – Established Patients – 25 Minutes
- 99215 – E/M – Established Patients – 40 Minutes
- 99443 – Telephone therapy (psychiatrist), – limit 3 units/hours per application
Mental Health CPT Code Cheat Sheet
Download a copy of our PDF Behavioral Health CPT Code Cheat Sheet!
CPT Coding for Therapy
CPT coding for psychotherapy doesn’t have to be difficult! There are an overwhelming amount of total CPT Codes (~8,000), however only 24 are specifically designated for psychotherapy and other mental health services.
To make matters even simpler, nearly all therapists will regularly use an even smaller subset of these 24.
CPT is a large and dynamic code set that changes year to year, but the psychotherapy codes seldom change.
The most recent change for psychotherapy codes took place in 2019, then 2013, and previously 1998.
To ensure your coding is current and up to date, consider using a billing service instead of having to remember all the codes.
Behavioral Health CPT Add-On Codes
A CPT Add-on Code is a code describing a service performed in in conjunction with a primary service. Many of these add-on codes are associated with a specific CPT Code or a small set of CPT Codes and cannot be used otherwise.
For instance, the behavioral health CPT Code for interactive complexity (+90785) can be used for a diagnostic (90791, 90792) or a normal psychotherapy session (90832, 90834, 90837) but not a crisis psychotherapy session (90839).
Add-on Codes are identified by a + sign in front of the number, i.e. +90840 is an add-on code for extra time in the case of crisis psychotherapy.
On CMS 1500 forms CPT Add-on codes are simply added on a new line.
Add-on codes are extremely important to use in order to most accurately describe the services being rendered and to ensure your services are maximized per session.
We help the mental health providers that work with us in our billing service do all of this for every appointment.
Mental Health Testing CPT Codes [2020]
These codes are only effective January 1st, 2019.
Assessment of Aphasia and Cognitive Performance Testing CPT Codes
CPT Code 96105
Assessment of aphasia (includes assessment of expressive and receptive speech and language function, language comprehension, speech production ability, reading, spelling, writing, e.g., by Boston Diagnostic Aphasia Examination) with interpretation and report, per hour
CPT Code 96125
Standardized cognitive performance testing (e.g., Ross Information Processing Assessment) per hour of a qualified health care professional’s time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report
Developmental/Behavioral Screening and Testing
CPT Code 96110
Developmental screening (e.g., developmental milestone survey, speech and language delay screen), with scoring and documentation, per standardized instrument
CPT Code 96112
Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory, and/ or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report; first hour
Add-on CPT Code + 96113 – Each additional 30 minutes (List separately in addition to code for primary procedure)
Brief emotional/behavioral assessment (e.g., depression inventory, attention-deficit/hyperactivity disorder [ADHD] scale), with scoring and documentation, per standardized instrument
Psychological/Neuropsychological Testing CPT Codes
These codes have changed in 2019.
Neurobehavioral Status Exam CPT Codes
CPT Code 96116
Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgement, e.g., acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities), by physician or other qualified health care professional, both faceto-face time with the patient and time interpreting test results and preparing the report; first hour
Add-on CPT Code +96121 – Each additional hour (List separately in addition to code for primary procedure)
Test Evaluation Services CPT Codes
CPT Code 96130
Psychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report and interactive feedback to the patient, family member(s) or caregiver(s), when performed; first hour
Add-on CPT Code +96131 – Each additional hour (List separately in addition to code for primary procedure)
CPT Code 96132
Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report and interactive feedback to the patient, family member(s) or caregiver(s), when performed; first hour
Add-on CPT Code +96133 – Each additional hour (List separately in addition to code for primary procedure)
Test Administration and Scoring CPT Codes
CPT Code 96136
Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method, first 30 minutes
Add-on CPT Code +96137 – Each additional 30 minutes (List separately in addition to code for primary procedure)
CPT Code 96138
Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; first 30 minutes
Add-on CPT Code +96139 – Each additional 30 minutes (List separately in addition to code for primary procedure)
Automated Testing and Result CPT Codes
96146 – Psychological or neuropsychological test administration, with single automated instrument via electronic platform, with automated result only
Mental Health Evaluation & Management (E/M) Codes
There are also E/M (evaluation & management) in conjunction with psychotherapy, used by authorized prescribers, psychiatrists, and MDs.
Coding E/M is trickier, harder to document and more vulnerable to audit but usually results in greater reimbursement.
There’s also a series of E/M codes that are used without the psychotherapy component.
For more in-depth coverage on E/M coding for psychotherapy there are some good free webinars released by AACAP on E/M CPT Codes.
- Add-on CPT Code +90833 – E/M code for 30 minutes of psychiatry (used with 90832).
- Add-on CPT Code +90836 – E/M code for 45 minutes of psychiatry (used with 90834).
- Add-on CPT Code +90838 – E/M code for 60 minutes of psychotherapy (used with 90837).
Key Points
- Psychotherapy must be at least 16 minutes.
- Time is very important and should be rounded to the nearest CPT Code.
- Outpatient vs. Inpatient is not important.
- E/M codes can only be used by prescribers (MD, DO, APN, PA).
Medicare 2022 Reimbursement Rates by CPT Code
CPT CodeDescriptionMedicare Reimbursement Rate 2020Medicare Reimbursement Rate 2021Medicare Reimbursement Rate 202290791Psychological Diagnostic Evaluation$140.19$180.75$195.4690792Psychological Diagnostic Evaluation with Medication Management$157.49$201.68$218.9090832Individual Psychotherapy, 30 Minutes$68.47$77.81$85.0790833Individual Psychotherapy with Evaluation and Management Services, 30 minutes$71.00$71.18$77.8890834Individual Psychotherapy, 45 Minutes$91.18$103.28$112.2990836Individual Psychotherapy with Evaluation and Management Services, 45 minutes$89.74$90.02$98.3090837Individual Psychotherapy, 60 Minutes$136.95$152.48$164.8490838Individual Psychotherapy with Evaluation and Management Services, 60 minutes$118.57$119.33$129.3090839Individual Crisis Psychotherapy initial 60 min$157.6690840Individual Crisis Psychotherapy initial 60 min, each additional 30 min$78.6499201Evaluation and Management Services, Outpatient, New Patient$46.49Not CoveredNot covered99202Evaluation and Management Services, Outpatient, New Patient$77.48$73.97$80.9199203Evaluation and Management Services, Outpatient, New Patient$109.92$113.75$124.3999204Evaluation and Management Services, Outpatient, New Patient$166.86$169.93$185.2699205Evaluation and Management Services, Outpatient, New Patient$209.75$224.36$244.9999211Evaluation and Management Services, Outpatient, Established Patient$23.07$23.03$25.7199212Evaluation and Management Services, Outpatient, Established Patient$45.77$56.88$62.7699213Evaluation and Management Services, Outpatient, Established Patient$75.32$92.47$100.5799214Evaluation and Management Services, Outpatient, Established Patient$110.28$131.20$141.7899215Evaluation and Management Services, Outpatient, Established Patient$147.76$183.19$200.0099354Prolonged Services$132.26 $132.09$140.2699355Prolong Services with E/M$100.91$100.33$101.3290846Family psychotherapy without patient, 50 minutes$103.58$99.10$107.3790847Family psychotherapy with patient, 50 minutes$107.19$102.59$111.1596105Assessment of aphasia and cognitive performance$101.54$109.2696112Developmental testing administration by a physician or qualified health care professional, 1st hr$131.55$141.0296113Developmental testing administration by a physician or qualified health care professional, each additional hour$58.62$66.5496116Neurobehavioral status exam performed by a physician or qualified health professional, first hour$97.00$104.7396121Neurobehavioral status exam performed by a physician or qualified health professional, additional hour$82.35$87.3496125Standardized cognitive performance test administered by health care professional$107.12$115.6996127Brief emotional and behavioral assessment$4.89$5.2996130Psychological testing and evaluation by a physician or qualified health care professional, first hour$120.73$132.7096131Psychological testing and evaluation by a physician or qualified health care professional, each additional hour$91.42$98.6896132Neuropsychological testing and evaluation by a physician or qualified health care professional, first hour$133.29$144.8096133Neuropsychological testing and evaluation by a physician or qualified health care professional, each additional hour$103.98$112.2996136Neuropsychological or psychological test administration and scoring by a physician or qualified health care professional, first hour$46.76$49.1596137Neuropsychological or psychological test administration and scoring by a physician or qualified health care professional, each additional hour$41.87$44.2496138Neuropsychological or psychological test administration and scoring by a technician, first hour$37.34$38.5696139Neuropsychological or psychological test administration and scoring by a technician, each additional hour$37.34$$39.32
(Source)
Interactive Complexity (+90785): Criteria and How to Bill
+90785 is one of the new add-on codes in the most recent CPT update in 2013.
This code is used as an umbrella add-on code and can be used for four different criteria. The most common scenarios usually involve children, although this is not necessarily always the case.
Common Examples of Interactive Complexity:
- The use of play equipment with young children.
- Interpreters/translators.
- Involvement of parents with discordant views that complicate the treatment plan.
- Report of abuse/neglect.
Interactive complexity can be used in conjunction with the primary CPT Codes for diagnostics, psychotherapy, or group therapy and cannot be used for couple/family therapy or crisis codes.
+90785, can be used with: 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90853.
Unsure when to use the interactive complexity code? Need help asking if it will be approved? Our billing service exclusively for mental health providers is here to help.
Am I Being Underpaid? Was I Paid the Right Amount?
Here’s typical rates depending on the therapist’s credentials:
Typical Reimbursements by Type of Therapist
Type of TherapistReimbursement/SessionSocial Workers~$55-60Marriage Family Therapists~$60-65Counselors~$60-65Psychologists~$70-80
These rates can vary significantly therapist to therapist but are good benchmarks for comparison.
How about CPT Codes? How do they affect the rate of reimbursement? This is a difficult and complex calculation, depending on the level of education, location, and license. The AMA has created a code search feature on their website that shows payment based off CPT Code and location.
This information is somewhat incomplete and is based off medicare payments and does not specify a number of other important factors. However, this tool is still very useful to compare the relative value CPT Codes against one another.
Private insurance will be correlated with some deviation from these numbers.
Reimbursement by CPT Code (Three Different Geographies)
Reimbursement (Rest of CA)Reimbursement (Los Angeles)Reimbursement (WA)
CodeCaliforniaLos AngelesWashington90791$137.10$141.17$132.9890792$147.84$152.16$143.3990832$66.14$68.03$64.25+90833$67.69$69.69$65.7090834$87.66$90.15$85.18+90836$85.71$88.21$83.1890837$131.28$134.95$127.54+90838$113.07$116.42$109.7590846$106.46$109.51$103.3890847$109.75$112.82$106.6090853$26.99$27.83$26.2190839$137.22$141.04$133.28+90840$65.75$67.61$63.89+90785$14.67$15.08$14.24
Data from AMA Codemanager. These numbers are useful for relative comparison of individual CPT Codes and geography.
Therapist Reimbursement Rates for 2022
Read our definitive guide with 2022 reimbursement rates for mental health CPT codes.
Downcoding Claims
Downcoding (including less services on the claim than actually provided) will usually mean you get paid less, while upcoding (including more services on the claim than actually provided) can get you in trouble with your managed care panels.
It’s also important to note that it might be tempting to maximize your CPT codes to earn higher reimbursements.
This is highly recommended against and can get you flagged, audited and removed from insurance panels. Even if this is your biller’s error, the therapist is the one who ultimately bears the responsibility and will be the one penalized.
Here’s a video guide we did of this article!
Distilled Guide to Mental Health CPT Codes
If you are just starting out or just beginning to deal with managed care, keep it simple.
CPT Codes appear far more complex from the outside looking in. Make a quick cheatsheet.
Don’t worry about memorizing all the CPT Codes (there’s alot!) or even all of the mental health ones. You will likely just use just a few individual codes.
Memorize the relevant codes and use google or other references to find the correct CPT codes for more unique scenarios.
Call to verify eligibility and benefits and make sure those codes will be approved with that client’s coverage.
And if all of that sounds like too much trouble, offload the work to us. You won’t have to know one CPT code from another to get your billing paid in full.
Additional Resources
Consider Outsourcing Your Billing
Don’t want to learn any of this stuff? We are your team of billing experts here to translate all of this gibberish into English! Reach out about our billing service if you are a licensed mental health provider (we only work with licensed mental health providers).
