Mental health, behavioral health, and psychotherapy services all use CPT codes to get reimbursed by insurance companies and government programs. However, there are some differences in the coding for these services:
- Psychotherapy: Therapists consider many factors when coding psychotherapy services, including timing, testing, assessment, crisis codes, and add-ons. Common CPT codes for psychotherapy include 90832 for 30 minutes, 90834 for 45 minutes, and 90837 CPT code for 60 minutes or more.
- Behavioral health: Behavioral health billing has many similarities to psychotherapy billing, but also focuses on social services. CPT codes for behavioral health services cover a wide range of services, including diagnostic assessments, psychotherapy sessions, medication management, and other interventions.
This blog is your expert guide for all the latest CPT codes for mental health. We will also explore the relationship between CPT & ICD-10 codes for your better understanding.
So, without any further ado, let’s dive into details.
Different types of CPT Codes for Mental Health
There are mainly three types of CPT codes for mental health.
1. Evaluation and Management Codes for Psychiatry Billing
E/M codes are used to report the complexity and time of mental health evaluation and management visits. The code you use will depend on the three conditions:
- the length of the visit
- the complexity of the patient’s condition
- the doctor’s decision-making level.
2. Psychotherapy Codes for Psychiatry Billing
Psychotherapy codes are used to indicate the duration and complexity of a psychotherapy session. The type of psychotherapy code used will be determined by:
- the length of the session,
- the type of therapy provided,
- and the patient’s age.
3. Other Psychiatry Billing Codes
Several additional CPT codes are used to report specific mental health services, including group family therapy, group therapy, and medication management.
How to Select the Correct CPT Codes?
It is important to consider the following factors, when selecting CPT codes for mental health:
- The type of service provided: The first step is to determine what type of mental health services were provided. This could be an E/M appointment, a psychotherapy session, or any other type of mental health service.
- The length of the service: The next step is to determine the duration of the service. To choose the proper CPT code, the duration of the service will be taken into account.
- The service’s complexity: This is another important thing to take into account. Generally, a higher-level CPT code will be used to report more complex services.
- The patient’s age: The age of the patient is another important consideration when choosing CPT codes for mental health services. For adults and children, there are different CPT codes.
Mental Health Add-On CPT Codes
Below, we have discussed the most common Add-On codes for routine outpatient CPT codes for mental health.
| Add-On CPT Code | Description |
| 90785 | Interactive complexity |
| 90863 | Pharmacologic Management after therapy |
| 99050 | Services are provided in the office at times other than regularly scheduled office hours or on days when the office is normally closed. |
| 99051 | Services are offered in the office during standard evening, weekend, or holiday office hours. |
| 99354 | Additional time following the 74-minute additional time. Adding another 30 minutes. (Only use it if your session lasts at least 90 minutes for 90837 or 80 minutes for 90847). |
| 99355 | Additional time after the first 60 minutes. The first additional 30 to 74 minutes. |
| 90840 | 30 additional minutes of psychotherapy for a crisis. Used exclusively in conjunction with CPT 90839. |
| 90833 | 30 minute psychotherapy add-on. |
| 90836 | 45 minute psychotherapy add-on |
Psychiatry Billing Mental Health Cpt Codes
Now let’s explore the CPT code for psychiatry medical billing with respect to mental health problems:
| Disorder | Initial Assessment Code | Therapy Code |
| Generalized Anxiety Disorder | 90801 | 90834 (45 minutes) |
| Social Anxiety Disorder | 90801 | 90834 (45 minutes) |
| Panic Disorder | 90801 | 90834 (45 minutes) |
| Major Depressive Disorder | 90801 | 90834 (45 minutes) |
| Persistent Depressive Disorder | 90801 | 90834 (45 minutes) |
| Bipolar I Disorder | 90801 | 90834 (45 minutes) |
| Bipolar II Disorder | 90801 | 90834 (45 minutes) |
| PTSD | 90801 | 90834 (45 minutes) |
| Anorexia Nervosa | 90801 | 90834 (45 minutes) |
| Bulimia Nervosa | 90801 | 90834 (45 minutes) |
| Binge Eating Disorder | 90801 | 90834 (45 minutes) |
| OCD | 90801 | 90834 (45 minutes) |
| Schizophrenia | 90801 | 90834 (45 minutes) |
Outpatient Psychiatry CPT Codes:
| Code | Type | Description | Time (Minutes) |
| 99201 | E/M | New Patient Office Visit | 10 |
| 99202 | E/M | New Patient Office Visit | 20 |
| 99203 | E/M | New Patient Office Visit | 30 |
| 99204 | E/M | New Patient Office Visit | 45 |
| 99205 | E/M | New Patient Office Visit | 60 |
| 99211 | E/M | Established Patient Office Visit | 5 |
| 99212 | E/M | Established Patient Office Visit | 10 |
| 99213 | E/M | Established Patient Office Visit | 15 |
| 99214 | E/M | Established Patient Office Visit | 25 |
| 99215 | E/M | Established Patient Office Visit | 40 |
| 99443 | Telephone therapy (psychiatrist) | 3 units/hours |
This table lists Evaluation and Management (E/M) service mental health CPT codes for new and established patients, along with their descriptions and typical durations. It also includes a code for telephone therapy by psychiatrists, limited to 3 units per hour per application.
Medicare 2024 Reimbursement Rates for Mental Health CPT Codes
| CPT Codes | Description | Medicare Reimbursement Rates |
| 90791 | Psychological Diagnostic Evaluation | $169.29 |
| 90792 | Psychological Diagnostic Evaluation with Medication Management | $190.57 |
| 90832 | Individual Psychotherapy, 30 Minutes | $76.95 |
| 90833 | Individual Psychotherapy with Evaluation and Management Services, 30 minutes | $70.73 |
| 90834 | Individual Psychotherapy, 45 Minutes | $101.51 |
| 90836 | Individual Psychotherapy with Evaluation and Management Services, 45 minutes | $89.39 |
| 90837 | Individual Psychotherapy, 60 Minutes | $149.64 |
| 90838 | Individual Psychotherapy with Evaluation and Management Services, 60 minutes | $118.53 |
| 90839 | Individual Crisis Psychotherapy initial 60 min | $144.07 |
| 90840 | Initial individual crisis psychotherapy session lasts for 60 minutes, with each additional session increment of 30 minutes | $71.38 |
| 99201 | Evaluation and Management Services, Outpatient, New Patient | Not covered |
| 99202 | Evaluation and Management Services, Outpatient, New Patient | $71.06 |
| 99203 | Evaluation and Management Services, Outpatient, New Patient | $109.69 |
| 99204 | Evaluation and Management Services, Outpatient, New Patient | $164.38 |
| 99205 | Evaluation and Management Services, Outpatient, New Patient | $216.77 |
| 99211 | Evaluation and Management Services, Outpatient, Established Patient | $22.92 |
| 99212 | Evaluation and Management Services, Outpatient, Established Patient | $55.67 |
| 99213 | Evaluation and Management Services, Outpatient, Established Patient | $89.39 |
| 99214 | Evaluation and Management Services, Outpatient, Established Patient | $126.07 |
| 99215 | Evaluation and Management Services, Outpatient, Established Patient | $177.47 |
| 99354 | Prolonged Services | Not covered |
| 99355 | Prolong Services with E/M | Not covered |
| 90846 | Family psychotherapy without patient, 50 minutes | $95.94 |
| 90847 | Family psychotherapy with patient, 50 minutes | $100.53 |
| 96105 | Assessment of aphasia and cognitive performance | $94.30 |
| 96112 | A physician or qualified healthcare professional typically administers developmental testing during the first hour | $121.81 |
| 96113 | Developmental testing administration by a physician or qualified health care professional, each additional hour | $58.94 |
| 96116 | During the first hour, a physician or qualified healthcare professional conducts a neurobehavioral status examination | $90.37 |
| 96121 | A physician or qualified healthcare professional conducts a neurobehavioral status examination during an additional hour | $73.67 |
| 96125 | Standardized cognitive performance test administered by health care professional | $100.53 |
| 96127 | Brief emotional and behavioral assessment | $4.58 |
| 96130 | In the first hour, a physician or qualified healthcare professional conducts psychological testing and evaluation | $117.88 |
| 96131 | Psychological testing and evaluation by a physician or qualified health care professional, each additional hour | $84.15 |
| 96132 | In the initial hour, a physician or qualified healthcare professional performs neuropsychological testing and evaluation | $126.07 |
| 96133 | Each additional hour, a physician or qualified healthcare professional conducts neuropsychological testing and evaluation | $95.61 |
| 96136 | A physician or qualified healthcare professional administers and scores neuropsychological or psychological tests during the first hour | $40.93 |
| 96137 | Neuropsychological or psychological test administration and scoring by a physician or qualified health care professional, each additional hour | $37.00 |
| 96138 | In the initial hour, a technician administers and scores neuropsychological or psychological tests | $33.73 |
| 96139 | For each additional hour, a technician conducts and scores neuropsychological or psychological tests | $34.71 |
Top Behavioral Health Cpt Codes In 2024
| CPT Code | Description |
| 90791 | Psychiatric diagnostic evaluation |
| 90792 | Psychiatric diagnostic evaluation with medical services |
| 90832, 90834, 90837 | Psychotherapy for 30, 45, and 60 minutes |
| 90845 | Psychoanalysis |
| 90846 | Family or couples therapy without patient present |
| 90847 | Family or couples therapy with patient present |
| 90849 | Multiple family group psychotherapy |
| 90853 | Group psychotherapy (other than a multiple-family group) |
| 90839 | Psychotherapy for crisis, 60 minutes |
| 90840 | Psychotherapy for crisis, each additional 30 minutes |
Mental Health Code Modifiers
| Code Modifier | Description |
| Modifier 25 | Evaluation and Management Services performed by a single provider, either on the same day as another service or independently identifiable |
| Modifier 27 | Several evaluation or management appointments occurred on the same day |
| Modifier 59 | A procedure that is distinct from other services provided on the same day |
| Modifier 95 | Audio-video counseling and therapy telehealth services |
| Modifier AF | Services rendered by a specialty physician |
| Modifier AH | Services rendered by a clinical psychologist |
| Modifier HA | Child or adolescent program |
| Modifier HB | Adult program, non-geriatric |
| Modifier HE | Mental health program |
| Modifier HF | Substance abuse program |
| Modifier HG | Opioid addiction treatment program |
| Modifier HK | Specialized mental health programs for high-risk populations |
| Modifier HQ | Group setting |
Final Verdict
We hope this guide on the mental health CPT codes was helpful to you. Note that the laws and regulations of CPT codes change yearly, so you need to be careful about that. We update our news sections, blogs, and articles on a daily basis so that you stay updated with the latest guidelines from healthcare regulatory bodies.
Resources:
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