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.
Billing and coding
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
| Code | Service | Time range | Who can bill it |
|---|---|---|---|
| 90832 | Psychotherapy, short session | 16 to 37 minutes | Licensed therapists and prescribers |
| 90834 | Psychotherapy, standard session | 38 to 52 minutes | Licensed therapists and prescribers |
| 90837 | Psychotherapy, extended session | 53 minutes or more | Licensed therapists and prescribers |
| 90845 | Psychoanalysis | Not time-defined | Providers trained in psychoanalysis |
Diagnostic evaluation
| Code | Service | Time range | Who can bill it |
|---|---|---|---|
| 90791 | Psychiatric diagnostic evaluation, no medical services | Not time-defined | Licensed therapists and prescribers |
| 90792 | Psychiatric diagnostic evaluation including medical services | Not time-defined | Prescribers only |
Family and group
| Code | Service | Time range | Who can bill it |
|---|---|---|---|
| 90846 | Family psychotherapy, client not present | 26 minutes or more | Licensed therapists and prescribers |
| 90847 | Family psychotherapy, client present | 26 minutes or more | Licensed therapists and prescribers |
| 90849 | Multiple-family group psychotherapy | Not time-defined | Licensed therapists and prescribers |
| 90853 | Group psychotherapy (other than multiple-family) | Not time-defined | Licensed therapists and prescribers |
Crisis
| Code | Service | Time range | Who can bill it |
|---|---|---|---|
| 90839 | Psychotherapy for crisis, first unit | 30 to 74 minutes | Licensed therapists and prescribers |
| +90840 | Psychotherapy for crisis, each additional unit | Each additional 30 minutes | Licensed therapists and prescribers |
Add-on codes
| Code | Service | Time range | Who can bill it |
|---|---|---|---|
| +90785 | Interactive complexity | Not time-based | Licensed therapists and prescribers |
| +90833 | Psychotherapy add-on to an E/M service, short | 16 to 37 minutes | Prescribers only |
| +90836 | Psychotherapy add-on to an E/M service, standard | 38 to 52 minutes | Prescribers only |
| +90838 | Psychotherapy add-on to an E/M service, extended | 53 minutes or more | Prescribers only |
| +90863 | Pharmacologic management add-on to psychotherapy | Not time-based | Prescribers, when the appointment is primarily psychotherapy rather than E/M; may be used in collaborative care settings |
Evaluation and management, new patient
| Code | Service | Time range | Who can bill it |
|---|---|---|---|
| 99202 | E/M visit, new patient, straightforward | 15 to 29 minutes | Prescribers only |
| 99203 | E/M visit, new patient, low complexity | 30 to 44 minutes | Prescribers only |
| 99204 | E/M visit, new patient, moderate complexity | 45 to 59 minutes | Prescribers only |
| 99205 | E/M visit, new patient, high complexity | 60 to 74 minutes | Prescribers only |
Evaluation and management, established patient
| Code | Service | Time range | Who can bill it |
|---|---|---|---|
| 99212 | E/M visit, established patient, straightforward | 10 to 19 minutes | Prescribers only |
| 99213 | E/M visit, established patient, low complexity | 20 to 29 minutes | Prescribers only |
| 99214 | E/M visit, established patient, moderate complexity | 30 to 39 minutes | Prescribers only |
| 99215 | E/M visit, established patient, high complexity | 40 to 54 minutes | Prescribers only |
Optional: After-hours and special circumstances
| Code | Service | Time range | Who can bill it |
|---|---|---|---|
| 99050 | Service provided outside regularly scheduled office hours | Not time-based | Verify by payer |
| 99051 | Service provided during regularly scheduled evening, weekend, or holiday hours | Not time-based | Verify 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.
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.
Billing and coding
Headway strives to simplify billing insurance so you can focus on providing care. Read our comprehensive guide to mental health billing.
The 90837 CPT code is often understood to be the standard of a therapy session among providers. However, insurers have a tendency to flag 90837 more frequently than other codes.