CPT Code 90833: Guide to Billing and Reimbursement

CPT code 90833 is essential for mental health professionals and medical coders when billing for specific psychotherapy services. Understanding how this code functions within the context of therapy sessions can help medical billers, coders, and healthcare providers ensure they are reimbursed appropriately for their services.

In this article, we will break down CPT code 90833, how it applies, its importance, and best practices for coding and billing this service correctly, helping providers avoid denials, ensure compliance, and capture the full value of the care they deliver.

CPT Code 90833 Description

CPT code 90833 is a code used to report psychotherapy sessions that are provided alongside evaluation and management (E/M) services. This specific CPT code is used when a healthcare provider delivers psychotherapy to a patient in a session lasting anywhere between 16 to 37 minutes.

This code refers to psychotherapy services conducted with patients who are undergoing E/M services, such as a routine check-up or a general medical consultation.

The key component of CPT 90833 is that psychotherapy is provided in conjunction with the E/M service, which means the 90833 CPT code should be billed alongside other codes like 99212, 99213, or 99214, depending on the nature and duration of the medical evaluation and management.

Who Can Bill CPT Code 90833?

CPT 90833 is exclusively billed by prescribing-level practitioners who provide both medical management and psychotherapy during the same session. Eligible providers include:

• Psychiatrists (MD, DO)
• Psychiatric Nurse Practitioners (PMHNP, APRN)
• Physician Assistants (PA) specializing in mental health

Non-prescribing mental health professionals, such as psychologists or licensed clinical social workers (LCSWs), cannot bill CPT 90833 because it is specifically tied to medical evaluation and medication management.

Reimbursement Rates for CPT Code 90833 (2025)

The Medicare reimbursement rate for CPT code 90833 typically ranges between $68.85 and $77.96, depending on whether the service is performed in a facility or non-facility setting.

For private payers, reimbursement for CPT 90833 generally ranges from $72.97 to $107.51, depending on the insurance provider, contracted agreements, and state-specific variations.

However, exact rates vary by region, state, and your Medicare Administrative Contractor (MAC). To ensure accurate payment, always review your MAC’s current fee schedule, verify contracted rates with private insurers, and make sure your documentation clearly supports medical necessity.

CPT Code 90833 Billing Guide

To successfully bill CPT 90833, follow these essential steps:

• Confirm Patient Eligibility: Verify if the patient’s insurance covers CPT 90833 along with an E/M service. Some insurers require prior authorization for extended psychotherapy.
• Document Medical Necessity: Clearly state why psychotherapy was needed in addition to medical management. Ensure both services are justified in the documentation.
• Record Session Start and End Times: Separate the E/M visit time from psychotherapy time. At least 30 minutes must be dedicated to psychotherapy.
• Use the Correct Billing Code Combination: Bill CPT 90833 alongside the appropriate E/M code. If more psychotherapy time is needed, consider codes like 90836 or 90838.
• Apply the Proper Modifiers (If Required): Some payers require modifier 25 on the E/M code to show psychotherapy was a separate service.

Documentation Tips for CPT 90833

Proper documentation is crucial for avoiding audits and ensuring reimbursement. Here are some documentation tips:

• Time of Psychotherapy: Clearly document the amount of time spent on psychotherapy. This can include direct notes about the techniques used or a description of the session.
• Psychotherapy Techniques: Note which therapy techniques were used during the session (e.g., cognitive behavioral therapy, dialectical behavior therapy, etc.).
• E/M Services: Record the evaluation and management services provided, including any diagnostic or medical history taken and the management strategies discussed.
• Patient’s Condition: Document any relevant details regarding the patient’s mental health condition that was addressed during the therapy session.

Tips for Maximizing Reimbursement for CPT Code 90833

To avoid claim denials and ensure full reimbursement, keep these expert tips in mind:

• Ensure Clear Documentation: Psychotherapy and medical management must be documented separately. The medical visit should focus on medication management, while psychotherapy notes should highlight therapeutic techniques and patient progress.
• Verify Telehealth Coverage: CPT 90833 can be billed for in-person and virtual visits, but coverage varies by insurer. Some payers require specific telehealth modifiers, so checking guidelines beforehand helps prevent claim denials.
• Use a Structured Note Format: Keeping E/M and psychotherapy notes distinct improves claim accuracy. Clearly define sections for medical management, symptoms, medications, psychotherapy approach, and treatment progress.
• Bill the Correct Code: CPT 90833 requires at least 30 minutes of psychotherapy. If the session is longer, use 90836 for 45 minutes or 90838 for 60 minutes to ensure proper billing.
• Conduct Routine Audits: Regular audits help maintain compliance and prevent revenue loss due to billing errors. Staying updated on insurance policies ensures accurate claim submissions and maximized reimbursement.

Common Mistakes to Avoid When Billing CPT 90833

Many claims for CPT 90833 are denied due to documentation errors. Avoid these common mistakes:

• Failing to Separate E/M and Psychotherapy Documentation: The claim may be rejected if the psychotherapy session is not distinctly documented.
• Billing CPT 90833 Without an E/M Code: Since 90833 is an add-on code, it must always be paired with an E/M code.
• Not Meeting the Minimum Time Requirement: CPT 90833 requires at least 16 minutes of psychotherapy; anything less cannot be billed.
• Including Medication Management Time in Psychotherapy Time: Medication review cannot be counted toward psychotherapy time.

CPT Code 90833 vs. 90832: A Common and Costly Point of Confusion

One of the biggest errors in mental health billing is confusing CPT code 90833 with its “standalone” cousin, CPT code 90832. Their descriptions look almost identical, but their use is completely different.

• CPT Code 90832: Psychotherapy, 30 minutes with patient
• CPT Code 90833: Psychotherapy, Approx. 30 minutes (16-37 Minutes) with the patient, when performed with an E/M service

Conclusion

CPT Code 90833 helps prescribing mental health providers bill for psychotherapy alongside medication management. To avoid reimbursement issues, keep therapy and E/M documentation separate, log session times accurately, and follow billing guidelines. If you’re billing for telehealth, confirm coverage beforehand. Staying on top of these details ensures smooth billing and quality patient care.