Mental health CPT codes describe what a behavioral health clinician did: 90791 or 90792 for the diagnostic evaluation, 90832, 90834 or 90837 for individual psychotherapy by time, add-ons 90833, 90836 or 90838 when psychotherapy rides on an E/M visit, and separate codes for crisis, family and group therapy.
Most therapy claim problems come down to a handful of rules: the minute thresholds that separate one psychotherapy code from the next, which codes can be paired on the same day, and which add-on codes need a primary code. Get those right and most coding denials disappear.
This reference covers every core psychiatry and psychotherapy code in the 90785 to 90853 range, the related screening and integrated care codes, and the 2026 Medicare national payment for each one. It focuses on the codes themselves. For the claim form and session workflow, see our step-by-step guide on how to bill for mental health therapy, and for the big picture, our mental health billing guide.
Key Takeaways
- Psychotherapy time decides the code: 16 to 37 minutes is 90832, 38 to 52 is 90834, and 53 or more is 90837. Under 16 minutes is not reportable.
- Prescribers who do an E/M visit plus psychotherapy report the E/M code with add-on 90833, 90836 or 90838, using the same time bands. Psychotherapy minutes cannot also count toward the E/M.
- Crisis psychotherapy 90839 needs at least 30 minutes and covers up to 74; add +90840 for each further 30 minutes. It cannot be billed with 90785, 90791, 90792 or 90832 to 90838 on the same day.
- Interactive complexity, +90785, requires one of four specific factors. Using an interpreter alone does not qualify.
- In 2026, Medicare’s national non-facility rate is $113.90 for 90834 and $167.00 for 90837, before locality (GPCI) adjustment.
Mental Health CPT Code Quick Reference
| Code | What it describes | Time rule | Typical billers |
|---|---|---|---|
| 90791 | Psychiatric diagnostic evaluation, no medical services | Not time-based | Psychologists, LCSWs, LPCs/MHCs, LMFTs, prescribers |
| 90792 | Psychiatric diagnostic evaluation with medical services | Not time-based | Psychiatrists, PMHNPs, PAs |
| 90832 | Psychotherapy, 30 minutes, with patient | 16 to 37 min | All licensed therapists |
| 90834 | Psychotherapy, 45 minutes, with patient | 38 to 52 min | All licensed therapists |
| 90837 | Psychotherapy, 60 minutes, with patient | 53 min or more | All licensed therapists |
| +90833 | Psychotherapy add-on with E/M, 30 minutes | 16 to 37 min | Prescribers billing E/M |
| +90836 | Psychotherapy add-on with E/M, 45 minutes | 38 to 52 min | Prescribers billing E/M |
| +90838 | Psychotherapy add-on with E/M, 60 minutes | 53 min or more | Prescribers billing E/M |
| +90785 | Interactive complexity add-on | Not time-based | Any clinician, with an eligible primary code |
| 90839 | Psychotherapy for crisis, first 60 minutes | 30 to 74 min | All licensed therapists |
| +90840 | Crisis psychotherapy, each additional 30 minutes | From 75 min | With 90839 only |
| 90846 | Family psychotherapy without the patient, 50 minutes | See family section | Therapists |
| 90847 | Family psychotherapy with the patient, 50 minutes | See family section | Therapists |
| 90853 | Group psychotherapy, other than multiple-family group | Per session | Therapists |
| +90863 | Pharmacologic management with psychotherapy | Not time-based | Prescribing clinicians who cannot bill E/M |
| 96127 | Brief emotional or behavioral assessment, per standardized instrument | Per instrument | Any clinician |
Diagnostic Evaluation: 90791 vs 90792
Both codes describe the initial assessment: history, mental status, diagnosis and treatment plan. The difference is the medical component. 90792 adds medical services such as a medication review, physical exam elements or ordering labs, so it is used by clinicians licensed to provide them. Therapists and psychologists bill 90791.
Neither code is time-based, and neither can be billed with psychotherapy or crisis codes for the same patient on the same day. Many payers also limit how often 90791 or 90792 can be billed per patient, so a reassessment months later may need a payer-specific justification.
Individual Psychotherapy: 90832, 90834 and 90837
Pick the code whose time is closest to the actual psychotherapy time. First Coast’s Medicare billing article for psychiatric services spells out the bands below, and requires start and stop times or total time in the note.
| Code | Time band | 2026 total RVU (non-facility) | 2026 Medicare national, non-facility | 2026 Medicare national, facility |
|---|---|---|---|---|
| 90832 | 16 to 37 min | 2.57 | $85.84 | $69.47 |
| 90834 | 38 to 52 min | 3.41 | $113.90 | $91.85 |
| 90837 | 53 min or more | 5.00 | $167.00 | $135.27 |
Payment formula. Total RVU x $33.4009 (the 2026 non-QP conversion factor) = national amount. Your local amount changes with the geographic adjustment (GPCI) for your Medicare locality.
Medicare pays clinical social workers, marriage and family therapists and mental health counselors 75% of the physician fee schedule amount, so their actual Medicare rate is lower than the national figure shown. Commercial and Medicaid rates follow each contract.
Do not round up. A 50-minute session is 90834, not 90837. Payers watch the share of 90837 claims per clinician, and a note that does not show 53 minutes of psychotherapy will not support the higher code on audit.
Psychotherapy With E/M: Add-Ons 90833, 90836 and 90838
Psychiatrists, psychiatric nurse practitioners and physician assistants often manage medication and provide psychotherapy in the same visit. In that case, report the E/M code (for example 99213 or 99214) plus the psychotherapy add-on that matches the psychotherapy time. The same 16 to 37, 38 to 52 and 53+ minute bands apply.
- The E/M must be separately identifiable from the psychotherapy, and the note should show both.
- Psychotherapy minutes are excluded from E/M time. Choose the E/M level by medical decision making, or by E/M time that does not include the psychotherapy minutes.
- Prolonged service codes cannot be reported with these add-ons.
- Under CPT, no modifier 25 is needed on the E/M because the two services do not bundle. Some commercial plans publish their own policy, so check each payer.
| Add-on | Time band | 2026 total RVU (non-facility) | 2026 Medicare national, non-facility |
|---|---|---|---|
| +90833 | 16 to 37 min | 2.44 | $81.50 |
| +90836 | 38 to 52 min | 3.09 | $103.21 |
| +90838 | 53 min or more | 4.09 | $136.61 |
Psychiatry practices face extra prior authorization and medication management rules on top of this. Our guide to psychiatry billing denial management covers that workflow.
Interactive Complexity: +90785
90785 is an add-on for sessions where communication factors make the service harder to deliver. It pays little ($14.70 national non-facility in 2026), but it is frequently misused. CPT recognizes four qualifying factors:
- Maladaptive communication. Managing high anxiety, high reactivity, repeated questions or disagreement among participants that complicates care.
- Caregiver interference. A caregiver’s emotions or behavior interfere with their understanding of, or ability to help with, the treatment plan.
- Sentinel event. Evidence or disclosure of an event, such as suspected abuse, that requires a mandated report to a third party, with discussion involving the patient or other participants.
- Play equipment or devices. Using play therapy, physical devices or an interpreter to overcome barriers with a patient who is not fluent or lacks the communication skills for the visit.
Report 90785 with 90791, 90792, 90832 to 90838 and 90853. It can go with an E/M only when a psychotherapy add-on is also billed, and the interactive complexity relates to the psychotherapy. It is never billed with 90839 or 90840, and it is not used with family psychotherapy codes.
Do not bill 90785 just because an interpreter was used. Translation or interpretation alone is not interactive complexity. One of the four factors must be documented.
Crisis Psychotherapy: 90839 and +90840
Crisis codes cover urgent assessment and psychotherapy for a patient in high distress, including efforts to reduce the crisis and safety planning. Time is total face-to-face time with the patient and/or family that day, and it may be noncontinuous, but the clinician must give the patient full attention for that time.
| Total crisis time | Codes to report | 2026 Medicare national, non-facility |
|---|---|---|
| Under 30 min | Use 90832 or 90833 instead | See tables above |
| 30 to 74 min | 90839 x 1 | $160.32 |
| 75 to 104 min | 90839 + 90840 x 1 | $160.32 + $77.16 |
| 105 to 134 min | 90839 + 90840 x 2 | $160.32 + $154.32 |
CMS also created HCPCS G0017 and G0018 for crisis psychotherapy furnished in non-facility settings other than the office, such as the patient’s home. Bill 90839 only once per date, and never with 90791, 90792 or 90832 to 90838 for that patient that day.
Family and Group Psychotherapy
| Code | Who is present | Key rule | 2026 Medicare national, non-facility |
|---|---|---|---|
| 90846 | Family only, patient absent | Treatment must focus on the patient’s condition | $105.88 |
| 90847 | Family with patient | Patient present for all or part of the session | $109.55 |
| 90853 | Group of unrelated patients | Billed per patient, per session; 90785 may be added | $30.39 |
Both family codes are written as 50-minute services, and CPT instructs that they should not be reported for sessions of 25 minutes or less. Medicare covers 90846 only when the patient’s treatment is the focus, not the family members’ own issues. Group therapy notes should list the group type, the patient’s participation and progress, and the session length, even though 90853 is not time-based.
Other Codes Behavioral Health Practices Use
| Code | Use | Note |
|---|---|---|
| 96127 | Brief standardized screening tool, such as PHQ-9 or GAD-7 | Billed per instrument; 2026 Medicare national non-facility $5.01 |
| +90863 | Pharmacologic management with psychotherapy | For prescribing psychologists and others who cannot bill E/M; coverage varies by payer |
| 99484 | General behavioral health integration care management | At least 20 minutes of clinical staff time per calendar month |
| 99492 to 99494 | Psychiatric collaborative care model | 70 minutes in the first month, 60 in later months, plus 30-minute add-on |
| G0323 | Behavioral health care management by therapists | Medicare code for psychologists, social workers, MFTs and MHCs, at least 20 minutes per month |
Codes That Are Often Confused
| Pair | The difference | Common error |
|---|---|---|
| 90834 vs 90837 | 52 minutes or less vs 53 minutes or more | Billing 90837 for 45 to 50 minute sessions |
| 90837 vs 90838 | Standalone psychotherapy vs add-on with E/M | Prescribers billing 90837 plus an E/M |
| 90791 vs 90792 | No medical services vs medical services | Therapists billing 90792 |
| 90837 vs 90839 | Routine therapy vs crisis | Using crisis codes for long routine sessions |
| 90846 vs 90847 | Patient absent vs present | Wrong code when the patient joins partway |
Worked Example: Same Visit, Two Coding Paths
A psychiatric nurse practitioner sees an established patient. Medication review and adjustment take 15 minutes and support a moderate-complexity E/M. The clinician then provides 28 minutes of documented psychotherapy.
Correct coding. 99214 (based on medical decision making) + 90833 (28 minutes falls in the 16 to 37 minute band). No 90785 unless one of the four factors is documented.
Wrong coding. 90834 alone loses the E/M. 99214 + 90836 overstates the psychotherapy, because 15 E/M minutes cannot be added to the 28 psychotherapy minutes.
For a therapist, the same logic is simpler: a session with 54 minutes of documented psychotherapy is 90837, while a 50-minute session is 90834. Both claims also need a diagnosis that supports medical necessity; see our guide to mental health ICD-10 codes.
Documentation Checklist for Every Session
- Start and stop times, or total psychotherapy time, for every time-based code.
- Session type, modality (in person, video or audio-only) and who was present.
- Interventions used, such as CBT or trauma-focused therapy, and the patient’s response.
- Link to treatment plan goals and medical necessity for the length and frequency of care.
- For 90785, the specific qualifying factor; for crisis codes, the nature of the crisis and safety plan.
Telehealth and Modifiers in Brief
The same CPT codes are used for telehealth. What changes is the place of service (POS 02 or POS 10) and the modifier, such as 95 for audio-video or 93 for audio-only where allowed. Medicare and commercial rules differ, so we cover them separately in our guide to telehealth mental health CPT codes, modifiers and POS rules.
Most coding denials for therapy practices trace back to time documentation, add-on codes billed without a primary code, or same-day code conflicts. Our guide to behavioral health billing denials shows how to fix and prevent each one.
Want every session coded to the minute and every add-on captured? Steady Medical Billing’s mental health billing team codes, submits and follows up on therapy and psychiatry claims for you.
Frequently Asked Questions
What is the difference between 90834 and 90837?
Both are individual psychotherapy codes. 90834 covers 38 to 52 minutes of psychotherapy and 90837 covers 53 minutes or more. In 2026 the Medicare national non-facility rate is $113.90 for 90834 and $167.00 for 90837, before locality adjustment.
Can a therapist bill 90832 for a 15-minute session?
No. Psychotherapy of less than 16 minutes is not reportable. 90832 starts at 16 minutes and runs to 37 minutes.
Do I need modifier 25 when billing an E/M with 90833?
Under CPT rules, no. The psychotherapy add-on codes are designed to be reported with an E/M, and the two services do not bundle. A few payers have their own policies, so check each contract.
When can I bill interactive complexity 90785?
Only when one of four factors is documented: maladaptive communication, caregiver interference, a sentinel event requiring a mandated report, or use of play equipment, devices or an interpreter to overcome communication barriers. An interpreter alone does not qualify, and 90785 is never billed with crisis codes 90839 or 90840.
How do I code a 90-minute crisis session?
Report 90839 once for the first 30 to 74 minutes and 90840 once for the time from 75 to 104 minutes. Do not add 90785, 90791 or routine psychotherapy codes for that patient on the same date.
