Behavioral Health CPT Codes and Billing Requirements

By Jack Whittaker | February 3, 2026

Table of Contents

Introduction

Navigating the complex world of behavioral health billing can be challenging for healthcare providers. With the increasing demand for mental health services and the expansion of integrated care models, understanding the correct Current Procedural Terminology (CPT) codes for behavioral health has never been more critical. Accurate coding ensures proper reimbursement, reduces claim denials, and maintains compliance with payer requirements.

At HealthArc, we understand the importance of streamlined billing processes for behavioral health services. Our digital health platform helps providers maximize their revenue while delivering exceptional patient care. This comprehensive guide will walk you through the most common CPT codes for behavioral health, billing requirements, and best practices to optimize your reimbursement.

Most Common CPT Codes for Behavioral Health

Behavioral health providers use a specific set of CPT codes to bill for their services. While there are thousands of CPT codes in the medical field, mental health professionals typically work with a focused subset of approximately two dozen codes. Here are the most frequently used behavioral health billing codes:

Psychiatric Diagnostic Evaluation Codes

90791:Psychiatric Diagnostic Evaluation (without medical services) – Used for initial intake assessments by psychologists, LCSWs, LPCs, and other qualified mental health professionals.
90792:Psychiatric Diagnostic Evaluation with Medical Services – Used by psychiatrists and other medical professionals who can prescribe medication during the evaluation.

Individual Psychotherapy Codes

90832:Psychotherapy, 30 minutes (16-37 minutes) – Brief therapy sessions.
90834:Psychotherapy, 45 minutes (38-52 minutes) – Standard therapy session, most commonly billed.
90837:Psychotherapy, 60 minutes (53+ minutes) – Extended therapy sessions for complex cases.

Behavioral Health CPT Codes

Family and Group Therapy Codes

90846:Family Psychotherapy (without patient present) – When conducting family therapy with family members only.
90847:Family Psychotherapy (with patient present) – Family or couples therapy including the identified patient.
90853:Group Psychotherapy – Therapy sessions conducted with multiple patients.

Crisis Intervention Codes

90839:Psychotherapy for Crisis, First 60 Minutes – Initial crisis intervention services.
90840:Add-on for each additional 30 minutes – Used with 90839 for extended crisis sessions.

Behavioral Health Integration (BHI) CPT Codes

Behavioral Health Integration has transformed how primary care practices address mental health. The Centers for Medicare & Medicaid Services (CMS) established specific CPT codes to support integrated care models:

General BHI Codes

99484:General Behavioral Health Integration – Care management services for behavioral health conditions, requiring at least 20 minutes of clinical staff time per calendar month.
G0323:Care Management Services for Behavioral Health Conditions – Allows clinical psychologists and clinical social workers to bill for behavioral health care management (20+ minutes per month).

Collaborative Care Model (CoCM) Codes

99492:Initial Psychiatric Collaborative Care Management – First 70 minutes in the first calendar month of behavioral health care manager activities.
99493:Subsequent Psychiatric Collaborative Care Management – First 60 minutes in subsequent months.
99494:Add-on for Additional 30 Minutes – Can be billed with either 99492 or 99493.
G2214:Initial or Subsequent Psychiatric CoCM – First 30 minutes in any month for care manager activities.

Collaborative care team approach to behavioral health integration

Documentation Requirements for Behavioral Health Billing

Proper documentation is essential for successful reimbursement. Medicare and commercial payers require specific elements to be documented for each service billed:

Required Documentation Elements

Session Date and Duration:Record exact start and end times to support time-based coding.
Service Location:Include place of service code (office, telehealth, etc.).
Patient Present:Document that the patient was present for the service (required for most codes).
Clinical Content:Summarize the therapeutic intervention, patient response, and progress toward treatment goals.
Treatment Plan:Reference the current treatment plan and any modifications made.
Medical Necessity:Document why the service was medically necessary for the patient’s condition.

Telehealth Billing for Behavioral Health Services

The expansion of telehealth has been one of the most significant changes in behavioral health delivery. In 2025, Medicare and most commercial payers continue to support telehealth flexibilities for mental health services:

Key Telehealth Updates for 2025

Geographic Restrictions Removed:Patients can receive telehealth services from any location, including their homes.
In-Person Visit Requirement Waived:The requirement for an in-person visit within 6 months prior to telehealth services is suspended through September 30, 2025.
Audio-Only Services:Medicare continues to allow audio-only telehealth for mental health services when video is not available.
Modifier 95:Use modifier 95 for synchronous telehealth services.
Place of Service:Use POS 10 (telehealth in patient’s home) or POS 02 (telehealth not in patient’s home).

Virtual behavioral health services via telehealth platforms

Medicare Reimbursement Rates for Behavioral Health CPT Codes (2026)

Understanding reimbursement rates helps practices project revenue and make informed decisions about service offerings. Here are the 2026 Medicare reimbursement rates for common behavioral health codes:

CPT Code	Description	2026 Rate
90791	Psychiatric Diagnostic Evaluation	$173.35
90792	Psychiatric Diagnostic Eval w/ Med Services	$202.08
90832	Psychotherapy, 30 minutes	$85.84
90834	Psychotherapy, 45 minutes	$113.90
90837	Psychotherapy, 60 minutes	$167.00
90847	Family Psychotherapy (with patient)	$109.55
90853	Group Psychotherapy	$30.39
99484	General BHI Care Management	$63.09
99492	Initial Psychiatric CoCM	$185.36
99493	Subsequent Psychiatric CoCM	$132.57

Note: Reimbursement rates vary by geographic location and are typically higher for providers in areas with higher cost of living. Commercial payer rates may differ significantly from Medicare rates.

Common Billing Mistakes to Avoid

Even experienced billers can make errors that lead to claim denials or delayed payments. Here are the most common mistakes and how to avoid them:

Time-Based Coding Errors

One of the most frequent errors is incorrect time-based coding. Always round to the nearest appropriate code based on actual face-to-face time, not scheduled time. Document start and end times clearly in your progress notes.

Missing Documentation

Insufficient documentation is a leading cause of claim denials. Ensure your notes support the level of service billed, including medical necessity and the specific interventions provided.

Incorrect Use of Add-On Codes

Add-on codes like 90840 (additional crisis time) and 90785 (interactive complexity) can only be billed with their corresponding base codes. Verify that you meet all requirements before billing add-on codes.

Billing E/M and Psychotherapy on the Same Day

When billing both an E/M service and psychotherapy on the same day by the same provider, use modifier 25 on the E/M code to indicate it was a separately identifiable service.

Frequently Asked Questions (FAQs)

FAQ 1: What CPT code should I use for a standard 45-minute therapy session?

Use CPT code 90834 for individual psychotherapy sessions lasting
38–52 minutes. This is the most commonly billed psychotherapy code
and represents the standard session length for most practices. Always document
the actual session time in your progress notes to support the code selection.

FAQ 2: Can I bill 90837 for every therapy session?

No, you should not use 90837 for every session. This code is intended
for extended psychotherapy sessions lasting 53 minutes or more.
Overuse without proper documentation of medical necessity can trigger audits
and claim denials. Use 90834 for standard sessions and reserve
90837 for clinically complex cases.

FAQ 3: What is the difference between CPT 90791 and 90792?

The key difference is medical services. CPT 90791
is a psychiatric diagnostic evaluation without medical services and is typically
used by psychologists, LCSWs, LPCs, and LMFTs. CPT 90792 includes
medical services such as medication evaluation and prescribing, and can only
be billed by providers with prescribing authority.

FAQ 4: How do I bill for telehealth behavioral health services?

For telehealth behavioral health services, use the same CPT codes as in-person
visits (such as 90832, 90834, 90837) with
modifier 95. Use Place of Service 10 if the patient
is at home or POS 02 if they are in another location. Be sure to
document that the service was provided via real-time, interactive video
(or audio-only if allowed).

FAQ 5: Can I bill BHI and CCM codes for the same patient?

Yes, you can bill both Behavioral Health Integration (BHI) and
Chronic Care Management (CCM) codes for the same patient in the
same month. However, the time requirements are separate. You must provide
at least 20 minutes of BHI and 20 minutes of CCM
services, and the same time cannot be counted toward both programs.

FAQ 6: What are the requirements for billing Collaborative Care Model (CoCM) codes?

To bill CoCM codes (99492–99494), your practice must implement the
full Collaborative Care Model. This includes a billing practitioner, a trained
behavioral health care manager, and a psychiatric consultant. Services must
involve registry-based tracking, weekly psychiatric consultation, and
evidence-based treatment interventions.

FAQ 7: How do I document medical necessity for behavioral health services?

Medical necessity documentation should include the patient’s diagnosis using
appropriate ICD-10 codes, specific symptoms or functional impairments,
how treatment will improve the condition, and a treatment plan with measurable
goals. Ongoing notes should reflect progress and justify continued care.

FAQ 8: What modifiers are commonly used with behavioral health CPT codes?

Common modifiers include 25 (separately identifiable E/M service),
95 (telehealth), GT (telehealth for some payers),
and 59 (distinct procedural service). Modifier requirements vary
by payer, so always verify Medicare, Medicaid, and commercial insurer guidelines.

Conclusion

Understanding behavioral health CPT codes and billing requirements is essential for practice success. Accurate coding ensures proper reimbursement, reduces claim denials, and maintains compliance with payer requirements. As the healthcare landscape continues to evolve, staying current with coding updates and best practices is crucial.

At HealthArc, we’re committed to helping healthcare providers navigate the complexities of behavioral health billing. Our digital health platform includes automated billing documentation for Behavioral Health Integration, Collaborative Care Management, and other care coordination services. With HealthArc, you can focus on delivering exceptional patient care while we help optimize your revenue cycle.

For more information about how HealthArc can support your behavioral health billing needs, visit our website at www.healtharc.io or contact our team to schedule a demo.