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Every mental health CPT code (and when to bill it)

Understand the ins and outs of CPT codes to help make documentation and billing more efficient — and give you more time to focus on other areas of your practice.

December 21, 2023 • Updated on October 28, 2026

By the Headway Editorial Team

19 min read

By the Headway Editorial Team

What to know

1

Many mental health providers use psychotherapy CPT codes, such as 90834 and 90837, for the large majority of their sessions.

2

Session length determines which standalone psychotherapy code to use.

3

Add-on codes and E/M codes follow different rules than standalone psychotherapy codes, so be careful when documenting and billing more complex sessions.

4

Headway’s all-in-one EHR includes features that simplify documentation and claim submission, so you can focus on patient care.

An introduction to CPT codes

Current Procedural Terminology (CPT) codes are a common numerical language for healthcare professionals to describe the services they provide. As a mental health practitioner, understanding the ins and outs of CPT codes can make documentation and billing more efficient, ultimately saving you time to focus on other areas of your practice.

Depending on your licensure and area of practice, you may find yourself using certain CPT codes more than others. Read on for more info on the most common CPT codes for mental health (and how to use them).

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It’s important to use the code that most accurately reflects the time you spent with the patient to treat their condition, and ensure that documentation for the session supports the chosen code.

What are mental health CPT codes?

CPT codes describe the specific services provided in a mental health appointment. They are distinct from ICD-10 codes, which describe a client’s diagnosis.

Think of it this way: An ICD-10 code explains why you treated a client, and a CPT code describes how you treated them. If you saw a client with generalized anxiety for a 45-minute psychotherapy session, you’d use ICD-10 code F41.4 (generalized anxiety disorder) and CPT code 90834 (psychotherapy, standard session).

The full list of mental health CPT codes

You’ll naturally use some CPT codes more often than others, but it’s helpful to know your options. Below is a full list of mental health CPT codes.

Psychotherapy

CodeServiceTime rangeWho can bill it
90832Psychotherapy, short session16 to 37 minutesLicensed therapists and prescribers
90834Psychotherapy, standard session38 to 52 minutesLicensed therapists and prescribers
90837Psychotherapy, extended session53 minutes or moreLicensed therapists and prescribers
90845PsychoanalysisNot time-definedProviders trained in psychoanalysis

Diagnostic evaluation

CodeServiceTime rangeWho can bill it
90791Psychiatric diagnostic evaluation, no medical servicesNot time-definedLicensed therapists and prescribers
90792Psychiatric diagnostic evaluation including medical servicesNot time-definedPrescribers only

Family and group

CodeServiceTime rangeWho can bill it
90846Family psychotherapy, client not present26 minutes or moreLicensed therapists and prescribers
90847Family psychotherapy, client present26 minutes or moreLicensed therapists and prescribers
90849Multiple-family group psychotherapyNot time-definedLicensed therapists and prescribers
90853Group psychotherapy (other than multiple-family)Not time-definedLicensed therapists and prescribers

Crisis

CodeServiceTime rangeWho can bill it
90839Psychotherapy for crisis, first unit30 to 74 minutesLicensed therapists and prescribers
+90840Psychotherapy for crisis, each additional unitEach additional 30 minutesLicensed therapists and prescribers

Add-on codes

CodeServiceTime rangeWho can bill it
+90785Interactive complexityNot time-basedLicensed therapists and prescribers
+90833Psychotherapy add-on to an E/M service, short16 to 37 minutesPrescribers only
+90836Psychotherapy add-on to an E/M service, standard38 to 52 minutesPrescribers only
+90838Psychotherapy add-on to an E/M service, extended53 minutes or morePrescribers only
+90863Pharmacologic management add-on to psychotherapyNot time-basedPrescribers, when the appointment is primarily psychotherapy rather than E/M; may be used in collaborative care settings

Evaluation and management, new patient

CodeServiceTime rangeWho can bill it
99202E/M visit, new patient, straightforward15 to 29 minutesPrescribers only
99203E/M visit, new patient, low complexity30 to 44 minutesPrescribers only
99204E/M visit, new patient, moderate complexity45 to 59 minutes Prescribers only
99205E/M visit, new patient, high complexity60 to 74 minutesPrescribers only

Evaluation and management, established patient

CodeServiceTime rangeWho can bill it
99212E/M visit, established patient, straightforward10 to 19 minutesPrescribers only
99213E/M visit, established patient, low complexity20 to 29 minutesPrescribers only
99214E/M visit, established patient, moderate complexity30 to 39 minutesPrescribers only
99215E/M visit, established patient, high complexity40 to 54 minutesPrescribers only

Optional: After-hours and special circumstances

CodeServiceTime rangeWho can bill it
99050Service provided outside regularly scheduled office hours Not time-basedVerify by payer
99051Service provided during regularly scheduled evening, weekend, or holiday hours Not time-basedVerify by payer

Which code should you bill?

Choosing a CPT code isn’t always as cut-and-dry as it may seem. Below, we’ve broken down some common sources of confusion and how to make the right decision.

  • 90832 vs. 90834 vs. 90837: How much face-to-face time did you spend delivering therapy?
  • Standalone psychotherapy vs. an E/M code plus a psychotherapy add-on: Did medical evaluation and management services happen in the same visit as psychotherapy? (Note that only prescribers may use E/M codes.)
  • 90833 vs. 90836 vs. 90838: How much face-to-face time did you spend delivering therapy, separate from E/M services provided?
  • 90791 vs. 90792: Were medical services part of the evaluation?
  • 90837 vs. 90839: Was the session in response to an urgent crisis, rather than a regularly scheduled session?
  • 90846 vs. 90847: Was the primary client present for family therapy?
  • 90847 vs. 90853: Were the session participants related or unrelated?

This document is intended for educational purposes only. It is designed to facilitate compliance with payer requirements and applicable law, but please note that the applicable laws and requirements vary from payer to payer and state to state. Please check with your legal counsel or state licensing board for specific requirements.

Add-on codes and when to use them

  • 90785: Use when communication difficulties are significant enough to influence your clinical approach, such as when working through an interpreter or managing an emotional caregiver. This add-on code cannot be applied to every session.
  • 90833, 90836, 90838: Use with an E/M code when psychotherapy was also provided during the same session. Select your add-on code based on the length of psychotherapy, not the total appointment time.
  • 90840: Use along with code 90839 (psychotherapy for crisis) for each additional 30 minutes beyond the initial 74.
  • 90863: Use this add-on for a session that is primarily psychotherapy, with pharmacologic management services added on. Note that this code is used relatively infrequently and may not be reimbursed by all payers.

E/M codes for prescribers

Prescribers bill E/M codes for medically oriented care, either delivered on its own or in addition to psychotherapy.

When using an E/M code alone, a prescriber can use one of two methods to select the correct code: medical complexity of the case, or the total amount of time spent on the client’s care in one day. When using an E/M code with a psychotherapy add-on, however, a prescriber must select a code based on medical complexity.

Whichever decision-making method you use, it’s important to back it up with thorough documentation. See more about what’s required in our guide to E/M codes.

Common documentation mistakes that affect billing

Two therapists billing for the exact same CPT code may earn different payouts. That’s because the code, itself, isn’t the only factor that determines reimbursement rates — although it’s certainly an important one.

Other relevant factors include:

  • Licensure and credential type: Some insurers reimburse advanced practitioners, such as physicians, at higher rates than non-physician providers
  • Geography: Reimbursements rates vary from state to state, and may be higher in places with high costs of living or dominant health systems
  • Payer and plan: Each payer negotiates and sets its own reimbursement rates, so providers’ payments can depend on the plan their client holds
  • How rates were negotiated: Sometimes insurers negotiate with large swaths of their provider networks at once, other times with a specific employer or health system. Even these behind-the-scenes details can affect reimbursement rates

At Headway, we use the size and strength of our provider network to negotiate competitive reimbursement rates with our insurance partners. On average, Headway clinicians can earn about $27,000 more per year, compared to solo credentialing.

Common documentation mistakes that affect billing

Deciding which CPT code to use is only the first step. If you don’t back it up with thorough documentation, you could run into billing headaches.

Don’t forget to include and double check all relevant details about the session, such as the spelling of the patient’s name, the session’s location and length, and so on. Beyond the basics, your documentation must also support the billing code you selected. If, for example, you chose code 90839 or 90840 (psychotherapy for crisis), you must show that the presenting problem was life-threatening or otherwise demanded immediate attention. Failing to do so could lead to rejected or delayed claims.

Misusing modifier codes is another common documentation mistake. Make sure that the codes you’ve selected can be used together, and that you’ve adequately shown why they’re both relevant.

If this seems like a lot to keep track of, Headway can help. With educational resources and templates meant to streamline documentation and billing, Headway supports all of the administrative work that goes into providing good therapeutic care. 

Licensing requirements to consider when billing insurance

Only licensed health care providers who are in compliance with relevant state and insurance regulations can use CPT codes to bill insurance. Such requirements ensure that payers are covering only legitimate health care services.

That’s true across the board. But, additionally, some CPT codes can only be used by certain types of providers. A wide range of talk therapists — from licensed clinical social workers to psychologists — commonly use psychotherapy codes like 90837, 90834, and 90834. But codes such as 90792 (psychiatric diagnostic evaluation with medical services) may only be used by advanced practitioners, such as psychiatrists and nurse practitioners.

FAQs about mental health CPT codes

Can I bill a psychotherapy code and an E/M code for the same session?

Yes, as long as you’re a prescriber qualified to offer E/M services. Generally, you’ll bill an E/M code along with a psychotherapy add-on code such as 90833 or 90836.

What is the minimum session length I can bill for psychotherapy?

To use CPT code 90832, for a short psychotherapy session, you must provide at least 16 minutes of face-to-face client care.

Do CPT codes change every year?

Yes. CPT codes are updated each year, with most changes effective as of January 1.

What is the difference between a CPT code and an ICD-10 code?

An ICD-10 code explains why you treated a client (their diagnosis), and a CPT code describes how you treated them (the services provided). See common ICD-10 codes here.

Build a profitable practice with Headway

Billing insurance is a deceptively complex aspect of offering therapy, from choosing the right CPT code to producing documentation that adequately supports your selection.

Headway demystifies the process with tools like progress note templates and billing support, ensuring that claims go through without a hitch — and you get paid as much as you should every two weeks, like clockwork.

There’s a reason Headway is home to the largest network of insurance-accepting mental health providers in the U.S. — we make accepting and billing insurance as straightforward as it should be.

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This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.

© 2026 Therapymatch, Inc. dba Headway. All rights reserved. No part of this publication may be reproduced without permission.

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