CPT codes for mental health services are standardized medical billing codes used to report psychiatric evaluations, psychotherapy, crisis intervention, and medication management services to insurance payers.
Mental health practices use CPT codes to ensure accurate reimbursement, regulatory compliance, and consistent documentation across behavioral healthcare settings.
This guide explains core behavioral health CPT codes, including psychiatric diagnostic evaluations, time-based psychotherapy services, crisis management, group and family therapy, and evaluation and management visits.
CPT Code 90791
CPT Code 90791 is for Psychiatric Initial Assessment or “Intake” code used by non-prescribing level providers. 90791 is used to represent psychiatric diagnostic evaluation without medical services. This code covers the assessment of a patient’s mental health, including history, examination, and recommendations for treatment. It is commonly used for new patients or existing patients requiring a comprehensive reassessment.
Reimbursement Rate
Reimbursement rates for CPT 90791 vary by payer and region. On average, Medicare reimburses approximately $137.28 to $173.35, depending on the MAC locality. Private insurers may reimburse higher or lower based on negotiated contracts.
Billing CPT Code 90791
- Ensure detailed documentation includes history, mental status examination, and diagnostic assessment.
- Typically billed by licensed mental health non-prescribing level professionals, including therapists, psychologists, and licensed clinical social workers.
- This code is often limited to one use per patient per provider within a certain timeframe, depending on payer policies.
- Can be billed for in-office or telehealth visits if allowed by the payer.
Tips for Using CPT Code 90791
- Verify payer-specific guidelines on telehealth eligibility for this code.
- Document the patient’s presenting issues, clinical observations, and diagnosis to avoid denials.
CPT Code 90792
CPT Code 90792 is for Psychiatric Initial Assessment, an “Intake” code used by prescribing-level providers. This code applies to assessments that include a medical component, such as prescriptions of medications, lab orders, physical health evaluations, and mental health evaluations.
Reimbursement Rate
The medicare reimbursement rate for CPT 90792 typically ranges between $159.32 and $202.08, depending on the contracted MAC for your geographic location. Some private insurers may pay much higher.
Billing CPT Code 90792
- Include mental health evaluation, medication management, and any physical health assessments.
- Usually billed by psychiatrists, psychiatric nurse practitioners, and other licensed professionals with prescribing authority.
- May only be billed once per episode of care per provider unless otherwise specified by the payer.
- Add modifiers (e.g., GT for telehealth) when applicable based on the service setting.
Tips for Using CPT Code 90792
- Ensure detailed documentation of any medical services, prescriptions, or lab orders included in the session.
- Use CPT 90792 for prescribing level providers only.
- Check state-specific rules for billing telehealth services under this code.
CPT Code 90832
CPT Code 90832 is for Psychotherapy, 30 minutes, billed by non-prescribing level providers. Psychotherapy represents treatment techniques that a health care provider uses to help patients with a mental or behavioral illness, using different techniques. Documentation needs to include the focus of therapy and the issues addressed during the session.
Reimbursement Rate
Medicare reimbursement rate for CPT 90832 typically ranges between $75.86–$109.89. Refer to your MAC for exact reimbursement fees.
Billing CPT Code 90832
- Billed by non-prescribing level practitioners
- Detailed session notes need to be documented
- Documentation needs to include steps taken to overcome or manage mental and behavioral illness
Tips for Using CPT Code 90832
- Documentation must include start and end times
- Location can be office or virtual
- Documentation needs to include the focus on therapy
CPT Code 90833+
CPT Code 90833 is for Psychotherapy, a 30-minute add-on, billed by prescribing level providers. Doctors and nurse practitioners will need to document psychotherapy in addition to a medical visit. Documentation for both needs to demonstrate distinct needs for the services. Time must also be documented separating the two services.
Reimbursement Rate
Medicare reimbursement rate for CPT 90833 typically ranges between $69.35–$99.95. Refer to your MAC for exact reimbursement fees.
Billing CPT Code 90833
- Billed by prescribing level practitioners
- Separate documentation recorded for psychotherapy
- Documentation needs to include steps taken to overcome or manage mental and behavioral illness
Tips for Using CPT Code 90833
- Documentation must include start and end times
- Location can be office or virtual
- Documentation needs to include focus on therapy
CPT Code 90834
CPT Code 90834 is for Psychotherapy, 45 minutes, billed by non-prescribing level providers. Detailed documentation is needed for the therapy. Documentation needs to include the focus of therapy and the issues addressed during the session. Time spent on therapy needs to be clearly documented. The appointment time is not sufficient.
Reimbursement Rate
Medicare reimbursement rate for CPT 90834 typically ranges between $112.00–$145.01. Refer to your MAC for exact reimbursement fees.
Billing CPT Code 90834
- Billed by non-prescribing level practitioners
- Detailed session notes need to be documented
- Documentation to include steps taken to overcome or manage mental and behavioral illness
Tips for Using CPT Code 90834
- Document start and end times
- Location can be office or virtual
- Document the focus of therapy
CPT Code 90836+
CPT Code 90836 is for Psychotherapy, 45 minutes add-on, billed by prescribing level providers. Any provider who can prescribe medication can bill this code for add-on therapy. Documentation needs to clearly identify separate medication management visits and therapy sessions.
Reimbursement Rate
Medicare reimbursement rate for CPT 90836 typically ranges between $88.09-$102.50.
Billing CPT Code 90836
- Billed by prescribing-level practitioners
- Distinctly identifiable documentation recorded for psychotherapy
- Document steps taken to overcome or manage mental and behavioral illness
Tips for Using CPT Code 90836
- Therapy must include start and end times, separate from medication management time
- Location can be office or virtual
- Documentation needs to include focus on therapy
CPT Code 90837
CPT Code 90837 is for Psychotherapy, 60 minutes, billed by non-prescribing level providers. Documentation needs to include treatment techniques used to help patients with a mental or behavioral illness. Reminder to document start and end time. We see too many refund requests due to this issue.
Reimbursement Rate
Medicare reimbursement rate for CPT 90837 typically ranges between $148.25–$214.72. Refer to your MAC fee schedule.
Billing CPT Code 90837
- Billed by non-prescribing level practitioners
- Always verify you have valid authorization on file
- Verify coverage and collect the patient’s portion
Tips for Using CPT Code 90837
- Revise documentation template in regular time intervals
- For tele-visits, document Audio/Video
- Document detailed notes
CPT Code 90838+
CPT Code 90838 is for Psychotherapy billed by prescribing-level providers. Documentation for treatment of mental or behavioral illness through Psychotherapy has to be separately documented from medication management visits.
Reimbursement Rate
Medicare reimbursement rate for CPT 90838 typically ranges between $116.68–$167.95. Refer to your MAC for your contracted fees.
Billing CPT Code 90838
- Billed by prescribing-level practitioners
- Document detailed session notes
- Include steps taken to overcome or manage mental and behavioral illness
Tips for Using CPT Code 90838
- Documentation must include start and end times
- Location can be office or virtual
- Documentation needs to include focus on therapy
- Documentation is separate from medication management
CPT Code 90839
CPT Code 90839 is for Psychotherapy for crisis management. The situation presented is typically life-threatening and requires immediate attention. Interaction is directly between provider and patient. 90839 represents the first 30-74 minutes of crisis management.
Reimbursement Rate
Medicare reimbursement rate for CPT 90839 typically ranges between $148.47–$145.53. Refer to your MAC for your contracted fees.
Billing CPT Code 90839
- For Psychotherapy for crisis, the first 30-74 minutes
- Document detailed session notes
- Document direct interaction with the patient
Tips for Using CPT Code 90839
- Documentation must include start and end times
- Location is expected to be face-to-face
- Time spent with family should not be added
- The situation is typically life-threatening
CPT Code 90840
CPT Code 90840 is for Psychotherapy for crisis management, each additional 30 minutes. The provider can bill this add-on code past 75 minutes of therapy.
Reimbursement Rate
Medicare reimbursement rate for CPT 90840 typically ranges between $69.35–$99.95. Refer to your MAC for your contracted fees.
Billing CPT Code 90840
- For Psychotherapy for crisis, each additional 30 minutes
- Document detailed session notes
- Document direct interaction with the patient
Tips for Using CPT Code 90840
- Documentation must include start and end times
- Location is expected to be face-to-face
- Time spent with family should not be added
- The situation is typically life-threatening
CPT Code 90846, 90847, 90849, 90853
90846 is family therapy without the patient being present. CPT 90847 is for family therapy, which includes couple therapy. CPT 90849 is for multi-family group psychotherapy. CPT Code 90853 represents therapy which includes several patients: typically, 45-60 minutes.
Reimbursement Rate
Medicare reimbursement rate for:
- CPT 90846 – $96.09–$141.34
- CPT 90847 – $100.21-$147.38
- CPT 90849 – $34.99-$49.05
- CPT 90853 – $26.92-$38.91
Billing CPT Code 90846, 90847, 90849, 90853
- 90846 – Family therapy without the patient present
- 90847- Family therapy/Couple therapy
- 90853 – Group therapy
- 90849 – Multi-family group psychotherapy
Tips for Using CPT Code 90846, 90847, 90849, 90853
- Documentation must include start and end times
- Documentation needs to include a focus on therapy
Evaluation and Management Codes (99202-99205 and 99212-99215)
CPT 99202, CPT 99203, CPT 99204, CPT 99205, CPT 99212, CPT 99213, CPT 99214, and CPT 99215 are prescribing level practitioners, such as MDs and NPs can bill E&M codes for initial visits as well as other medical management visits. E&M coding rules are stringent. For coding based on medical decision-making, two out of three components of decision-making must be the level coded. If coding is based on time, it has to meet at least half the halfway mark of the required time.
Reimbursement Rate
Reimbursement rates vary by payer. You should review your insurance contracts for fees before signing with the insurance.
Billing Evaluation and Management Codes
- If you are a prescribing provider
- Can be billed by psychiatrists, psychiatric nurse practitioners, and other licensed professionals with prescribing authority.
- Keep an E&M audit sheet handy to regularly audit your documentation
Tips for Using Evaluation and Management Codes
- Indicate the complexity of the problems
- Document amount and complexity of data reviewed
- Carefully document risks and complications
Conclusion
Your documentation is part of the patient’s permanent health record. Therefore, it is important to make sure and code all services accurately. Providers billing for services first need to make sure they are contracted with insurance. One provider should never bill under another provider’s NPI, that is against the law.
Insurance will audit your billing and documentation throughout the year to ensure that billing is being done properly. To avoid pitfalls in billing and reimbursement, always follow insurance guidelines and stay compliant to create a thriving behavioral healthcare center.
