Behavioral Health CPT Codes: The 2026 Clinician's Guide to Accurate, Practical Billing

You know the feeling - session ends, the clinical work is done, but the billing puzzle sits there waiting. Which code captures what you actually did? Was that 45 minutes of psychotherapy long enough for 90837, or should you stick with 90834?

Here’s the thing: behavioral health CPT codes don’t have to be confusing. When you understand the logic behind CPT codes - what they measure, how they pair, and what documentation supports them - billing becomes faster and more accurate. That means fewer denials, cleaner revenue, and more time for the work that matters.

This guide walks you through the most commonly used behavioral health billing codes in 2025, with real-world scenarios, time thresholds, and documentation essentials. You’ll also find updates on telehealth services, behavioral health integration, and new HCPCS additions that affect how you bill this year as a qualified health care professional.

TL;DR

• Behavioral health cpt codes describe your service type, duration, and who was present - match your documentation to the code description and time threshold to avoid denials.
• Core psychotherapy codes (90832, 90834, 90837) are time-based with clear minute ranges; add 90785 for interactive complexity when communication is more difficult.
• Use E/M codes (99202–99215) for medication management; pair with psychotherapy add-ons (90833, 90836, 90838) when you provide both in the same visit.
• Behavioral health integration codes (99484, 99492, 99493) require tracking cumulative monthly time, care plans, and team collaboration - confirm payer rules before billing.
• Telehealth uses the same health cpt codes with modifier 95 and appropriate place of service; document modality and patient location in your note.

CPT Basics for Behavioral Health

What CPT Codes Do in Behavioral Health

Current procedural terminology codes describe what you did, for how long, and with whom. They drive reimbursement and payer rules, so your documentation must match the code description and time. When you bill 90834 for a 45-minute psychotherapy session, your note should reflect 38–52 minutes of face-to-face clinical work.

Think of mental health cpt codes as the translation layer between your clinical work and insurance payment. The more precisely your documentation aligns with the code requirements, the smoother your claims process runs. These behavioral health cpt codes form the foundation of accurate medical billing for mental health practitioners.

How to Pick the Right Code Fast

Start with service type: evaluation, psychotherapy, testing, crisis intervention, or care management services. Add time and any applicable add-ons - interactive complexity, prolonged services, or psychotherapy with E/M. Confirm payer specifics for telehealth services, modifiers, and monthly care management services before you submit.

Most billing errors come from mismatched time or missing modifiers. Check your payer’s policy for modifier requirements, especially when pairing E/M with psychotherapy add-ons. Using the correct cpt codes ensures you receive appropriate reimbursement for behavioral health services.

Core Psychotherapy and Evaluation Codes

Diagnostic Evaluation

90791 is your psychiatric diagnostic evaluation without medical services. 90792 adds medical services to the evaluation. Use either code once per intake episode as medically needed, and document history, mental status exam, risk assessment, diagnosis, and treatment plan.

Reserve these codes for initial assessment sessions where you’re gathering comprehensive history and formulating a diagnosis. You typically can’t bill both an evaluation code and a full psychotherapy session on the same day. This diagnostic evaluation establishes the baseline for ongoing behavioral health treatment.

Individual Psychotherapy

• 90832: 30-minute psychotherapy (16–37 minutes)
• 90834: 45-minute psychotherapy (38–52 minutes)
• 90837: 60-minute psychotherapy (53+ minutes)

Document start and stop times, specific interventions used, patient response, risk assessment, and treatment plan. If you spend 40 minutes in session, bill 90834. If you go 55 minutes, bill 90837.

Time thresholds matter for these common cpt codes. Spending 50 minutes and billing 90837 is correct. Spending 36 minutes and billing 90834 invites an audit. These are among the most common cpt codes used by mental health practitioners.

Psychotherapy with E/M Add-Ons

When you provide both medication management and psychotherapy services in the same visit, use an E/M code plus a psychotherapy add-on:

• 90833: 30-minute psychotherapy add-on (16–37 minutes psychotherapy time)
• 90836: 45-minute psychotherapy add-on (38–52 minutes psychotherapy time)
• 90838: 60-minute psychotherapy add-on (53+ minutes psychotherapy time)

Many payers require modifier 25 on the E/M code to show it was a separately identifiable service. Check your payer’s policy before billing. This combination allows qualified health care professional providers to capture both medication management and psychotherapy services in the same patient encounter.

Family and Group Psychotherapy

• 90846: Family psychotherapy without patient present
• 90847: Family psychotherapy with patient present (conjoint psychotherapy)
• 90849: Multiple-family group psychotherapy
• 90853: Group psychotherapy (non-family)

Use 90846 when the clinical need is to treat the family system without the identified patient in the room. Document who attended and the clinical rationale for the format. Use 90847 for conjoint psychotherapy when the patient participates in the family session.

Interactive Complexity Add-On

90785 is an add on code for when communication is more complex. Use it with allowed base codes like 90791, 90792, 90832, 90834, 90837, 90853, or 90839. Examples include use of an interpreter, high-risk safety issues requiring caregiver involvement, or communication barriers that significantly increase the complexity of delivering care.

Document what made it complex. “Used interpreter for Mandarin-speaking patient” or “Active safety planning with guardian due to acute suicidal ideation” justifies this add on code.

Psychotherapy for Crisis

90839 covers the first 60 minutes of crisis psychotherapy. 90840 adds each additional 30 minutes. Use these behavioral health codes for urgent, high-severity presentations requiring immediate attention and intensive interventions. Document safety assessment, de-escalation strategies, and coordination efforts.

These codes are for true crisis situations - active suicidal ideation, acute psychotic symptoms, or severe distress requiring immediate intervention. They’re not appropriate for routine sessions with high-risk clients.

Quick Reference Table: Common Psychotherapy Codes

Medication Management and E/M Pairing

E/M Codes for Psychiatry and Med Management

New patient visits use 99202–99205. Established patient visits use 99211–99215. Select the cpt code by medical decision making or total time on the date of service, following current procedural terminology rules published by the American Medical Association.

Time includes all activities on the date of service - reviewing records, ordering labs, counseling, and face-to-face time. Medical decision making considers the number and complexity of problems addressed, data reviewed, and risk of complications. These office visits form the primary service for medication management.

When to Add Psychotherapy

Use 90833, 90836, or 90838 when you provide psychotherapy along with E/M in the same patient visit. Psychotherapy time is counted separately from E/M time. Some payers require modifier 25 on the E/M code when pairing with psychotherapy add-ons - verify your payer’s policy.

Example: A 30-minute medication check plus 25 minutes of CBT work would be billed as 99213 (or 99214, depending on complexity) with modifier 25, plus 90833. This captures both management services in one encounter.

Testing and Health Behavior Codes

Psychological and Neuropsychological Testing

Testing evaluation services include test selection, administration, scoring, and interpretation:

• 96130: Psych testing evaluation, first hour
• 96131: Each additional hour
• 96132: Neuropsych testing evaluation, first hour
• 96133: Each additional hour

Test administration and scoring by the clinician uses 96136 (first 30 minutes) and 96137 (each additional 30 minutes). Administration by a technician uses 96138 and 96139.

Document instruments used, rationale for testing, total time spent, interpretation, and integrated report. Testing codes require detailed documentation to support medical necessity for assessing behavioral health conditions and psychiatric conditions.

Health Behavior Assessment and Intervention

These codes apply when you’re addressing health-related behaviors affecting physical conditions, not behavioral health conditions. 96156 covers health behavior assessment or reassessment. Individual intervention uses 96158 (initial 30 minutes) and 96159 (each additional 15 minutes).

Group intervention codes are 96164/96165. Family with patient present uses 96167/96168. Family without patient uses 96170/96171. These health behavior assessment codes support integrated health care approaches.

BHI and CoCM Codes for Integrating Behavioral Health

General Behavioral Health Integration

99484 covers general bhi services requiring 20+ minutes of clinical staff time per month, directed by the billing practitioner. Some payers prefer G0323, the CMS HCPCS code for general bhi. Both codes require a care plan, activity tracking, and ongoing communication between team members.

Document cumulative monthly time with date-stamped activities. Include care plan updates, measurement-based care scores, and communication logs. General bhi supports behavioral health care planning within primary care settings and requires patient consent before initiating services.

Collaborative Care Model (CoCM)

• 99492: Initial psychiatric collaborative care management, first 70 minutes in first month
• 99493: Subsequent month, first 60 minutes
• 99494: Each additional 30 minutes (add-on code)

CMS uses G2214 as an HCPCS refinement for cocm services. Check your payer’s preference. Collaborative care management requires three team roles: treating practitioner, behavioral health care manager, and psychiatric consultant. Care managers facilitate ongoing behavioral health integration and track outcomes.

Documentation Requirements for BHI/CoCM

Track cumulative monthly time with date-stamped activities. Include registry use, care plan updates, standardized measurement scores, and psychiatric consultation notes. Advance patient consent and initiating visit rules vary by payer - confirm requirements before billing.

Most denials happen when documentation doesn’t clearly show time spent or team collaboration. Use a tracking template to ensure you capture all required elements for care management services provided. Document continuous relationship with the same patient throughout the month to support these behavioral health integration codes.

Substance Use Screening and Brief Intervention

SBIRT Coding

99408 covers 15–30 minutes of structured screening and brief intervention for behavioral health conditions. 99409 covers greater than 30 minutes. Medicare often uses G0396 (15–30 minutes) and G0397 (greater than 30 minutes), while Medicaid services may use different codes.

Document the screening tool used, scores, brief intervention content, treatment plan, and referrals made. SBIRT codes require evidence of both screening and intervention, not just screening alone. These mental health services support early identification of substance use issues.

Telehealth Rules: Using Behavioral Health CPT Codes Virtually

Use the Same CPT Codes

Psychotherapy, evaluations, and many E/M services use the same health cpt codes via telehealth. Apply the required modifier and correct place of service - the cpt code itself doesn’t change.

This simplifies telehealth billing significantly. A 45-minute therapy session is still 90834, whether you’re in person or on video. Telehealth services maintain the same documentation standards as in-person care.

Common Telehealth Modifiers and POS

Modifier 95 indicates synchronous telemedicine services with real-time audio-video. GT is still used by some Medicaid plans. Place of service 10 indicates the patient’s home; 02 indicates another telehealth site. Confirm payer rules before billing.

Audio-only allowances exist for select mental health services with some Medicare Medicaid payers. Verify coverage before billing audio-only sessions - many payers still require video for synchronous telemedicine.

Charting Must Show Telehealth

Note the modality used, patient location, clinician location if required by your payer, patient consent obtained, and any technical limitations that affected the session. Simple documentation like “Session conducted via HIPAA-compliant video platform with patient at home” satisfies most requirements.

2025 Updates That Affect Behavioral Health CPT/HCPCS Use

Key Medicare Updates to Know

Medicare introduced G0560 for structured suicide risk safety planning for patients with psychiatric conditions. This code covers the time spent developing and documenting a collaborative safety plan with a patient at risk for suicide.

G0544 updates aligned to expand access and payment for crisis care services. Expanded interprofessional consultation options (G0546–G0551) are available under specific circumstances for complex case collaboration between qualified health care professional providers.

Digital Mental Health Treatment Codes

New and revised codes exist for digital therapeutics and remote care elements for mental health and behavioral health treatment. Adoption varies by payer - confirm effective dates, supervision rules, and documentation requirements before billing.

Actionable Takeaway

Check payer bulletins for which HCPCS versus health cpt codes they accept in 2025 before you submit claims. Payers don’t all move at the same speed, and using the wrong code format causes denials. This applies to both Medicare and Medicaid services.

Modifiers That Matter in Behavioral Health

Core Modifiers

Modifier 25 indicates a significant, separately identifiable E/M service on the same day as another procedure. Use it when pairing E/M with psychotherapy add-ons as an add on code - many payers require it.

Modifier 95 indicates synchronous telemedicine services for mental health services. GT is the telehealth modifier for some Medicaid services. Always verify which modifier your payer prefers for behavioral health services.

Sometimes Used

Modifier 59 indicates a distinct procedural service. It’s rare in psychotherapy settings. Modifier 52 indicates reduced services - use cautiously, and typically not needed for time-based psychotherapy codes.

Some Medicaid programs require payer-specific H-modifiers or provider-type modifiers. Check your state Medicaid manual for behavioral health billing requirements.

Documentation Essentials to Support the Code

What to Include Every Time

Document start and stop times for time-based services to show time spent. Record specific interventions used, patient response, safety and risk assessment, and treatment plan. For family psychotherapy or group psychotherapy sessions, note who was present and the purpose of the session.

Clear documentation protects you in audits and supports medical necessity. “Patient responded well to CBT interventions targeting avoidance behaviors” is better than “Good session.” This applies to all behavioral health services.

When Using Add-Ons or Complex Codes

For interactive complexity, describe the factor that increased complexity - interpreter use, high-risk safety issues, or caregiver involvement. For crisis services, show urgent presentation, risk assessment, de-escalation strategies, and coordination efforts.

For bhi services and cocm services, show cumulative monthly time, registry use, care plan updates, measurement-based care scores, and psychiatric consultation notes. Templates help ensure you capture all required elements for care management services provided under behavioral health integration programs. Document joint care planning with care managers when applicable.

Quick Coding Scenarios

Common Real-World Cases

45-minute individual therapy session by psychologist: Bill 90834. Document start and stop times plus interventions.

60-minute therapy with safety plan and parent coaching for adolescent: Bill 90837. Add 90785 as an add on if communication is complex due to parent involvement and high-risk safety issues.

Psychiatry visit with 20-minute medication management and 25-minute CBT: Bill 99213 or 99214 (depending on medical decision making or time) plus 90833. Many payers require modifier 25 on the E/M code for this established patient.

Family session with patient present, 50 minutes: Bill 90847 for conjoint psychotherapy. Document who attended and clinical rationale.

Crisis triage with active suicidal ideation requiring de-escalation and coordination for 75 minutes: Bill 90839 (first hour) plus 90840 (each additional 30 minutes). Document safety assessment and coordination.

General bhi monthly management by primary care team, 25 minutes total staff time: Bill 99484 or G0323 per payer preference for general bhi. Track and document all time-stamped activities showing clinical staff time.

Collaborative care management initial month with 75 minutes: Bill 99492 for cocm services in the same month. Document care managers’ activities, psychiatric consultation, and care plan development for the cocm model.

Conclusion

Getting behavioral health cpt codes right comes down to three things: matching service type to the correct cpt code, documenting time accurately, and understanding your payer’s specific rules. When your documentation clearly shows what you did, how long it took, and why it was medically necessary, claims go through smoothly.

Stay current on 2025 updates - especially new common procedure coding system codes for safety planning, crisis care, and digital therapeutics. Check payer bulletins before billing unfamiliar codes. Keep your notes specific, concise, and aligned with code requirements as a qualified health care professional.

When in doubt, verify the payer policy before you submit. Clean claims mean faster payment and less administrative hassle, giving you more time for the clinical work that matters. Whether you’re providing mental health billing services, behavioral health services, or integrating behavioral health into primary care, accurate coding ensures appropriate reimbursement.

FAQs: Behavioral Health CPT Codes

Is 90837 risky to bill?

No - use 90837 when psychotherapy time is 53+ minutes and medical necessity is clear. Document start and stop times, interventions, and clinical rationale. The risk comes from billing 90837 without adequate time or documentation. It’s one of the most common cpt codes for extended sessions.

Can I bill 90791 and 90837 on the same day?

Usually no. Most payers restrict billing a full diagnostic evaluation and full psychotherapy session on the same day. Check your payer’s specific policy, but plan for these services on separate dates.

Can I bill individual and group psychotherapy on the same day?

Some payers allow it with clear medical necessity for the same patient, but many restrict same-day billing of different therapy formats. Verify your payer’s policy before scheduling overlapping services.

Do I need modifier 25 with psychotherapy add-ons?

Many payers require modifier 25 on the E/M code when pairing it with psychotherapy codes as add on services (90833, 90836, 90838). This shows the E/M was a separately identifiable service. Always check your payer’s policy for these psychotherapy services.

Can I bill telehealth across state lines?

You must be licensed in the state where the patient is physically located during the session. Follow licensure rules first, then confirm the payer covers telehealth services in that state before billing for synchronous telemedicine services.

When should I use 90846 instead of 90847?

Use 90846 for family psychotherapy when the clinical need is to treat the family system without the identified patient present. Document who attended and the clinical rationale. Use 90847 when the patient participates in the family psychotherapy session.

What documentation supports 90785 for interactive complexity?

Note the specific factor that increased complexity - use of interpreter, involvement of caregivers due to high-risk safety issues, communication barriers, or other factors that made the session significantly more complex than typical psychotherapy. This add on code requires clear justification.

How do I track time for BHI and CoCM codes?

Use a time-tracking template that captures date-stamped activities throughout the month. Include care plan updates, measurement-based care administration, registry use, team communication, and psychiatric consultation. Cumulative monthly time must meet the threshold for behavioral health integration codes billed. Document continuous relationship with care managers.

Can I bill 90837 for a 50-minute session?

Yes, if the session was 50 minutes (within the 53+ minute range after accounting for documentation or clinical judgment). However, 50 minutes is very close to the 90834 threshold (38–52 minutes). Bill conservatively - if actual face-to-face psychotherapy time was 50 minutes, 90834 is safer unless you’re confident the time threshold was met.

What’s the difference between 99484 and 99492?

99484 covers general bhi (20+ minutes monthly). 99492 is the initial month of collaborative care management, requiring 70+ minutes in the first hour and a specific team structure with care managers (treating practitioner, behavioral health care manager, psychiatric consultant). The cocm model is more structured and time-intensive than general bhi. You cannot bill both codes in the same month for the same patient. The subsequent month code 99493 requires 60+ minutes for the established patient under collaborative care management services.