Mental health services are essential but getting paid for them depends heavily on accurate CPT coding, correct time reporting, and strong documentation. Even small mistakes can lead to denied claims, underpayment, or compliance risk. Because mental health billing rules differ from many other specialties, providers and practices need a clear understanding of which CPT codes apply to which services.
This guide walks through the most commonly used mental health CPT codes, explains when and how to use them, and highlights documentation and billing considerations that directly affect reimbursement.
CPT Codes in Mental Health
Mental health CPT codes describe the type of service provided, not just the diagnosis. Unlike many procedural specialties, mental health coding is largely time-based and influenced by the provider’s credentials and whether medical decision making is involved.
These codes are used to communicate with payers:
- What kind of mental health service was delivered
- How long did the service last
- Whether medical management was involved
- Whether the service was individual, family, or group-based
Mental health CPT codes generally fall into a few major categories: diagnostic evaluations, psychotherapy, medication management, crisis care, and group/family therapy.
Psychiatric Diagnostic Evaluation Codes
Diagnostic evaluation codes are used when a patient is being assessed for the first time or re-evaluated after a significant gap in care. These services focus on diagnosis and treatment planning, not therapy.
90791 – Psychiatric Diagnostic Evaluation
This code is used for a comprehensive mental health assessment without medical services. It is typically billed by non-prescribing providers such as psychologists and licensed therapists.
The evaluation usually includes:
- Detailed patient history
- Mental status examination
- Psychosocial and behavioral assessment
- Diagnostic impressions and treatment planning
Important billing note:
- This code is not time-based
- It is usually billed once per episode of care, not repeatedly
90792 – Psychiatric Diagnostic Evaluation with Medical Services
This code applies when the diagnostic evaluation includes medical decision-making, such as prescribing or adjusting medication.
It is commonly billed by:
- Psychiatrists
- Nurse practitioners
- Physician assistants
The service includes:
- Medical and psychiatric assessment
- Medication evaluation or initiation
- Diagnosis and treatment plan development
Key distinction:
The presence of medical services is what separates 90792 from 90791.
Psychotherapy CPT Codes (Time-Based Services)
Psychotherapy codes are among the most frequently used—and most denied—codes in mental health billing. These codes are selected based on face-to-face therapy time, not total appointment length.
Accurate time tracking is critical, as each code has a defined time range.
90832 – Psychotherapy, 30 Minutes
This code is used for shorter therapy sessions, typically lasting 16 to 37 minutes.
Common scenarios include:
- Brief follow-up visits
- Focused therapy interventions
- Early or transitional sessions
Documentation must clearly reflect:
- Session length
- Therapeutic interventions used
- Patient response and progress
90834 – Psychotherapy, 45 Minutes
This is the most commonly billed psychotherapy code, covering sessions of 38 to 52 minutes.
It is often used for:
- Standard individual therapy visits
- Ongoing treatment plans
Because it aligns with typical therapy session lengths, payers generally view this code as low risk when appropriately documented.
90837 – Psychotherapy, 60 Minutes
This code applies to extended therapy sessions lasting 53 minutes or more.
Important caution:
- This code is frequently audited
- Documentation must justify why extended time was medically necessary
Best practice:
Use this code only when clinically appropriate and well-supported by detailed notes.
Psychotherapy with Evaluation & Management (E/M)
Some mental health visits include both medical management and psychotherapy. In these cases, psychotherapy is billed as an add-on code to an E/M service.
These codes apply only when both services are clearly documented and distinct.
90833, 90836, 90838 – Psychotherapy Add-On Codes
These codes represent psychotherapy provided alongside an E/M visit:
- 90833 – 30 minutes
- 90836 – 45 minutes
- 90838 – 60 minutes
Billing requirements include:
- A separately documented E/M service
- Clear differentiation between medication management and therapy
- Accurate time reporting for psychotherapy only
Failure to separate documentation is a common cause of denial.
Medication Management and E/M Codes
Medication-only visits are billed using office visit E/M codes, not psychotherapy codes.
99202–99215 – Office or Outpatient E/M Services
These codes are used for:
- Psychiatric medication management
- Follow-up visits
- Medical decision-making without therapy
Code selection is based on:
- Medical decision-making complexity, or
- Total time spent on the date of service
Clear documentation of assessment, medication changes, and clinical reasoning is essential.
Group and Family Therapy Codes
Mental health treatment often involves families or groups, which require separate CPT codes and documentation standards.
90853 – Group Psychotherapy
This code is used for therapy delivered in a group setting with multiple patients.
Documentation should include:
- Group focus and goals
- Patient participation
- Therapeutic techniques used
Each patient is billed individually using the same code.
90846 – Family Therapy Without Patient
Used when family members are treated without the patient present, often for education or behavioral planning.
90847 – Family Therapy With Patient
Used when the patient participates actively in family therapy.
Correct selection depends on whether the patient was present during the session.
Crisis codes apply when a patient experiences an acute mental health crisis requiring immediate intervention.
90839 and 90840 – Psychotherapy for Crisis
- 90839 covers the first 60 minutes
- 90840 is billed for each additional 30 minutes
These codes require:
- Clear documentation of the crisis
- Description of immediate risk
- Interventions used to stabilize the patient
- Exact time spent
These are high-scrutiny codes and should be used carefully.
Telehealth Mental Health CPT Codes
Most mental health CPT codes can be billed for telehealth, but billing rules vary by payer.
Common requirements include:
- Correct place of service (POS 10 or POS 02)
- Telehealth modifier (often modifier 95)
- Documentation confirming virtual delivery
Always verify payer-specific telehealth policies to avoid denials.
Billing and Coding Errors in Mental Health — and How to Avoid Them
Even experienced mental health providers lose revenue due to small but costly billing and coding mistakes. These errors don’t just slow payments—they increase denials, trigger audits, and create compliance risks. Understanding where things go wrong is the first step toward building a clean, repeatable billing process.
Below are the most common mental health billing and coding errors, along with practical ways to prevent them.
Using the Wrong Psychotherapy Time Code
Mental health CPT codes are time-based, yet many claims are denied because the documented session length doesn’t match the billed code.
Providers estimate time instead of documenting it precisely or default to the same code for every visit.
How to avoid it:
- Record start and end times for every session
- Follow CPT time ranges strictly (not appointment length)
- Use 90837 only when the session truly exceeds 53 minutes
Overbilling Psychiatric Diagnostic Evaluations
Codes 90791 and 90792 are meant for initial or major reassessments, not routine does follow-ups.
Practices mistakenly rebill diagnostic codes when treatment continues or when patients return after short gaps.
How to avoid it:
- Bill diagnostic evaluations once per episode of care
- Use psychotherapy or E/M codes for follow-up visits
- Clearly document when a true re-evaluation is clinically required
Poor Separation of E/M and Psychotherapy Services
When medication management and therapy occur in the same visit, both services must be clearly distinct.
Documentation blends therapy and medical decision-making into a single note.
How to avoid it:
- Document E/M and psychotherapy as separate components
- Use correct psychotherapy add-on codes (90833–90838)
- Clearly note therapy time only, excluding E/M time
Missing or Incomplete Time Documentation
Payers closely review time-based mental health claims, and missing time details are a common reason for denial.
Notes describe therapy content but omit session duration.
How to avoid it:
- Always include total face-to-face time
- Ensure time supports the selected CPT code
- Keep documentation consistent across all sessions
Incorrect Provider Credentials
Not all providers can bill the same CPT codes, and mismatches lead to rejected claims.
Credentialing status or scope-of-practice rules are overlooked.
How to avoid it:
- Verify provider credentials before billing
- Match CPT codes to the provider’s licensure
- Keep payer enrollment records updated
Telehealth Coding Mistakes
Telehealth mental health services are widely covered, but billing rules vary by payer and state.
Incorrect place of service or missing telehealth modifiers.
How to avoid it:
- Use correct POS codes (02 or 10, per payer)
- Apply required telehealth modifiers (often 95)
- Document that services were provided virtually
Weak Medical Necessity Documentation
Even correctly coded claims are denied when medical necessity is unclear.
Notes lack clinical justification, progress updates, or diagnosis linkage.
How to avoid it:
- Clearly connect treatment to diagnosis
- Document progress, symptoms, and treatment goals
- Update treatment plans regularly
Reusing Templates Without Customization
Copy-paste notes may save time, but they raise red flags for payers.
Templates aren’t customized per session.
How to avoid it:
- Personalize notes for each visit
- Reflect on session-specific interventions and outcomes
- Avoid repetitive or identical language across visits
Conclusion
Mental health billing is more than selecting the right CPT code—it’s about precision, consistency, and compliance at every step. From choosing the correct time-based psychotherapy codes to documenting medical necessity and avoiding common billing errors, each detail directly affects reimbursement. Practices that follow a structured coding workflow experience fewer denials, faster payments, and stronger financial stability. When billing is handled correctly, providers gain the freedom to focus on patient care without constant revenue disruptions.
Turn Mental Health Billing into Predictable Revenue
Medix Revenue Group helps mental health practices eliminate denials, clean up coding errors, and get paid accurately and on time. Our specialty-focused billing and RCM experts manage your claims, AR, and compliance so revenue flows without the stress.
