Understanding the Language of Reimbursement: What Are CPT Codes?
CPT is Current Procedural Terminology. It is a database of coding created & updated by the American Medical Association (AMA). Every 5 digits represent a specific service like procedures and diagnosis through surgery. In mental health, there is billing for therapy, psychiatric evaluations, psychological testing, and crisis interventions.
These codes are a universal translator of your clinical work to the insurance company. Applying the right code is a vital step to guaranteeing that you will be compensated fairly and in a reasonable time for the work done. If the wrong code is submitted, there will be no reimbursement, the payment will be delayed, and it will cause a chain of questionable compliance on your part.
Essential Mental Health CPT Codes for Everyday Practice
While thousands of CPT codes exist, mental health providers typically use a focused subset. Here are the core codes you’ll use most frequently, broken down by service type.
Initial Evaluations and Diagnostic Assessments
Every client journey begins with a comprehensive assessment. These codes are typically used only once per client.
| CPT Code | Description | Key Details |
| 90791 | Psychiatric Diagnostic Evaluation | A standard intake evaluation without medical services. Often used by psychologists, social workers, and counselors. |
| 90792 | Psychiatric Diagnostic Evaluation with Medical Services | An initial evaluation that includes medical components, such as prescribing medication. Typically used by psychiatrists and psychiatric nurse practitioners. |
Individual Psychotherapy Sessions
These are the workhorse codes for therapy, and they are strictly time-based. Choosing the right one depends on the exact face-to-face time spent with the patient.
| CPT Code | Description | Time Frame |
| 90832 | Psychotherapy, 30 minutes | 16–37 minutes |
| 90834 | Psychotherapy, 45 minutes | 38–52 minutes |
| 90837 | Psychotherapy, 60 minutes | 53 minutes or more |
Pro Tip: Always document the session’s start and end times in your notes. This supports your code selection and is a best practice for compliance, especially with 2025 guidelines emphasizing clearer documentation.
Mental Health CPT Codes for Family, Couples, and Group TherapyÂ
Treatment often involves more than the individual.
- 90846: Family or couples psychotherapy without the patient present (50 minutes, typically 26+ minutes).
- 90847: Family or couples psychotherapy (conjoint therapy) with the patient present (50 minutes).
- 90853: Group psychotherapy (for multiple patients, not a family group).
Crisis Intervention Services
For urgent, life-threatening, or complex situations requiring immediate attention.
- 90839: Psychotherapy for crisis, first 60 minutes.
- +90840: Add-on code for each additional 30 minutes of crisis therapy (used with 90839).
Add-On Codes for Complex Situations
Some services are reported in addition to a primary code.
- +90785: Interactive Complexity. This add-on code is used with evaluation or psychotherapy codes (like 90791 or 90837) when specific complicating factors are present, such as engaging with hostile family members or communicating with a verbally undeveloped child. It cannot be reported for simple translation services.
Key Updates and Changes for 2025
The medical billing landscape constantly evolves. Here are the most important updates for mental health providers in 2025.
1. Telehealth Flexibility Is Here to Stay
One of the most significant shifts from the pandemic era has been solidified. Telehealth provisions for mental health have been extended and made largely permanent.
- No Geographic or In-Person Barriers: For Medicare and many major payers, patients can now receive tele-mental health services from their homes without prior in-person visit requirements, at least through late 2025.
- Audio-Only Services Remain an Option: In recognition of the digital divide, audio-only telehealth services, in some situations, continue to be valid for mental health care.
- How to Code: In general, mental health professionals will use the same CPT code as an in-person session (for example, 90837). You will then add a Place of Service (POS) code 02 (Telehealth) and a modifier 95 for some payers to indicate the service was provided in real time through audio or video telecommunications.
2. Collaborative Care Expansion
The integration of primary care and behavioral health has advertising and employing marketing and advertising behavioral health professionals. Rules and regulations, effective 2023, expand the scopes of practice of several disciplines.
Integration of behavioral healthcare strategies into the CoCM teams has made it possible for practices to hire Licensed Professional Counselors (LPCs) and Marriage and Family Therapists (MFTs) as behavioral health care managers.
Practices can now bill for psychiatric CoCM services using codes 99492 – 99494.
3. Clarity on Prolonged Services and Documentation
The AMA has provided clearer guidance on extended sessions:
- If a psychotherapy session goes significantly beyond 60 minutes, you may need to use an add-on prolonged service code (like +99417) in addition to 90837.
- Clearly justify the medical necessity of the extra time in your progress notes.
Navigating Common Billing Challenges
Getting Paid for What You Do: Evaluation & Management (E/M) + Psychotherapy
The integration of primary care and behavioral health has advertising and employing marketing and advertising behavioral health professionals. Rules and regulations, effective 2023, expand the scopes of practice of several disciplines.
Integration of behavioral healthcare strategies into the CoCM teams has made it possible for practices to hire Licensed Professional Counselors (LPCs) and Marriage and Family Therapists (MFTs) as behavioral health care managers.
Practices can now bill for psychiatric CoCM services using codes 99492 – 99494.
The Critical Role of Modifiers and Place of Service
- Modifiers: The two-digit codes offer further detail for a particular service. The codes 95 for telehealth, 25 for a significant, separate E/M service, and 59 for a separate additional procedural service are common examples.
- Place of Service (POS) Codes: This tells the payer where the service occurred. 11 is an office, 02 is telehealth, and 12 is home. Claim denial can stem from having the incorrect POS code.
FAQs
Q1: Are there different CPT codes for Telehealth Therapy?
No, you do not use different codes, but you do need to indicate telehealth settings by pairing it with Place of Service (POS) code 02, which remains the same for psychotherapy codes as an example 90837. ____ Verify the specific requirements with the payer to check if you need to use modifiers such as 95.
Q2: When do I use the code +90785 for interactive complexity as an addon?
If any complicating factor such as systemic communication barriers, severely emotionally distressed patients, etc., the complexity and the time for the session, then use it. Routine things do not count for that, and it should not be reported for simple translation workforce issues.
Q3: How do I bill for the session with me that includes both medication management and therapy?
You bill using Evaluation & Management (E/M) code (like 99214) and attach modifier 25, plus the appropriate psychotherapy add-on code (e.g., +90836). Both of those services need to be documented as performed separately for each.
Q4: Did the codes for psychotherapy for 2025 change?
For the psychotherapy codes that are time-based primarily, the core ones 90832, 90834, and 90837 did not change. However, other guidelines concerning telehealth have been updated, as well as about collaborative care models. Consult the current version of the AMA CPT manual for all rules.
Question 5: What is the importance of documenting session start and end times? Why is this reasonable?
Time documentation, in particular, is essential and is the reason the code is assigned (i.e., 38 minutes is 90834). This is also a basic requirement for compliance, audits, and evidence of medical necessity.