Medical billing for mental health services relies on specific coding to describe the care provided. In the United States, healthcare providers use CPT codes for mental health when filing insurance claims – CPT stands for Current Procedural Terminology, a standardized 5-digit code set maintained by the AMA. These codes are essentially the billing codes for mental health treatments and evaluations, ensuring that therapy sessions, psychiatric evaluations, and other services are properly documented and reimbursed.
There are thousands of CPT codes in medicine, but mental health billing uses a relatively small subset (around two dozen common codes). This complete 2025 guide will walk through the most common CPT codes for mental health, explain 2025 updates (including telehealth changes), and highlight key compliance details like modifiers, place-of-service, and documentation rules.
Understanding CPT Codes in Mental Health Billing
Every time a counselor, psychologist, or psychiatrist provides a service, they must choose the correct CPT code to describe it. These CPT codes for mental health tell insurance companies what service was given (for example, a 45-minute psychotherapy session or an initial evaluation). Using the right code is critical – it affects how you get paid and whether the claim is accepted. In other words, mental health billing depends on accurate CPT coding. The American Medical Association (AMA) defines CPT codes as standardized codes for reporting medical, surgical, and diagnostic services, and they apply to behavioral health services the same way they do for physical health.
Why are CPT codes important in Mental Health Billing?
They ensure that everyone (providers, insurers, and auditors) speaks the same language. For example, CPT code 90834 specifically means a 45-minute psychotherapy session. If a therapist accidentally billed a different code, the payer might deny the claim or pay the wrong amount. Accurate CPT billing codes mental health providers use also help with compliance; they show that services billed match the documentation in the client’s chart, reducing the risk of audits or fraud accusations. In summary, understanding mental health CPT codes is essential for clinics, group practices, and solo providers to get reimbursed correctly and avoid common billing problems.
Common CPT Codes for Mental Health
Mental health providers actually use a small family of CPT codes frequently. Below is a table of common CPT codes for mental health services, along with their descriptions and typical requirements. These are the codes most therapists and psychiatrists will use day-to-day for office visits (in-person or telehealth):
| CPT Code | Description | Typical Time / Details |
| 90791 | Psychiatric Diagnostic Evaluation | Initial intake evaluation (no medical services performed) – usually 1 per patient. |
| 90792 | Psych. Diagnostic Eval. with Medical Services | Initial evaluation including medical services (e.g. for psychiatrists who prescribe medication). |
| 90832 | Psychotherapy, 30 minutes | 16–37 minutes of face-to-face therapy (brief session). |
| 90834 | Psychotherapy, 45 minutes | 38–52 minutes of face-to-face therapy (standard session). |
| 90837 | Psychotherapy, 60 minutes | 53 or more minutes of face-to-face therapy (extended session). |
| 90846 | Family Psychotherapy without patient | Family or couples therapy, patient not present. |
| 90847 | Family Psychotherapy with patient | Family therapy with the patient present. |
| 90853 | Group Psychotherapy | Group therapy session for multiple patients (not family groups). |
| 90839 | Crisis Psychotherapy, first 60 min | Crisis intervention session, 15–60 minutes (can be up to 74 min). |
| +90840 | Crisis Psychotherapy, each add’l 30 min (add-on) | Add-on code for each additional 30 minutes of crisis therapy beyond the first 60 minutes (i.e. used if total time ≥ 75 min). |
Table: Key CPT codes mental health providers use for evaluations and therapy sessions. “Add-on” means the code is billed in addition to another primary code (e.g., 90840 is always with 90839).
In addition to the therapy visit codes above, some other behavioral health CPT codes you might encounter include:
Evaluation & Management (E/M) Codes:
Psychiatrists and certain nurse practitioners often bill general medical E/M visit codes (like 99212–99215 for outpatient visits) especially for medication management visits. If a session includes both psychotherapy and E/M (for example, a medication check + therapy), the provider can bill an E/M code plus a psychotherapy add-on code (90833 for 30 min, 90836 for 45 min, or 90838 for 60 min of therapy in the same visit). In such cases, a modifier 25 is usually added to the E/M code to show it’s a separate significant service on the same day (more on modifiers later).
Psychological Testing and Evaluation Codes:
For psychological or neuropsychological testing services, codes 96130, 96131 (test evaluation services) and 96136–96139 (test administration and scoring) are used by psychologists. For example, 96130 covers the first hour of psychological test evaluation (integration of results and report), and 96131 covers each additional hour. These ensure time spent on testing is billed properly.
Behavioral Health Integration (BHI) and Collaborative Care Model (CoCM) Codes:
These are management codes often used in primary care settings that integrate mental health care. For instance, 99484 is for general BHI care management (monthly) and 99492–99494 are for psychiatric CoCM services (initial and subsequent months of collaborative care). In 2025, CMS expanded who can deliver some of these services – for example, licensed counselors and marriage/family therapists can now participate in collaborative care teams for CoCM codes. These codes help practices bill for coordinated care activities (like a primary care doctor consulting with a psychiatrist and a care manager to help a patient with depression).
Remember that common CPT codes for mental health services are time-based for psychotherapy. Always choose the code that matches the session length. For instance, if you had a 50-minute therapy session, you’d use 90834 (45-minute code) because 50 minutes falls in the 38–52 minute range. If you reached 53 minutes, you could use 90837 for a longer session and potentially receive higher reimbursement. Accurately coding the time ensures you are compensated for the full session length without upcoding (overstating the service).
2025 Updates and Changes in Mental Health CPT Coding
The year 2025 brought some important updates to CPT codes for mental health, reflecting changes in how care is delivered (especially with telehealth) and efforts to improve clarity in coding. Here are some key 2025 updates that mental health clinics and providers should know:
Refinements to Psychotherapy Code Definitions:
The AMA updated some psychotherapy code guidelines to clarify their use. For example, CPT 90837 (53+ minutes psychotherapy) now has clearer documentation guidance on extended sessions – providers are encouraged to document start and end times and use add-on prolonged service codes if a psychotherapy session goes significantly beyond 60 minutes. Likewise, CPT 90834 (38–52 minutes) has an emphasis on recording the exact session time to justify using that code. In practice, this means clinicians should note the time spent in their progress notes (e.g. “Session start 2:00 PM, end 2:50 PM – 50 minutes total”) to support the CPT code billed. These changes help ensure coding accuracy and compliance with time-based rules.
Telehealth Provisions Made (Mostly) Permanent:
Perhaps the biggest change is the continuation and permanence of telehealth flexibilities for mental health services. During the COVID-19 pandemic, many restrictions on telehealth were lifted. In 2025, those provisions have largely been extended or made permanent for behavioral health. Telehealth services for most mental health CPT codes are now reimbursable by Medicare and major payers without geographic limits.
Patients can be seen from their home, and the old requirements that they live in certain areas or come in-person first have been suspended through at least late 2025. In fact, Medicare no longer requires an in-person visit within 6 months before starting tele-mental health (this in-person requirement is paused through September 30, 2025 by federal law). Moreover, audio-only services remain allowable for mental health in certain situations, recognizing that not all patients have video capability. (We’ll discuss telehealth coding specifics in the next section.)
New & Revised Codes:
The 2025 CPT code set introduced some new codes and revisions relevant to behavioral health. For instance, new digital therapeutics codes were added to describe prescription digital behavioral therapy tools (for example, apps or online programs prescribed to treat substance use or insomnia – these codes allow billing for monitoring patient use of FDA-approved digital therapies).
Additionally, prolonged service codes were revised – CPT 99417 (prolonged outpatient services) and others can be used alongside psychotherapy in certain cases (e.g., when a therapy session attached to an E/M service runs long, beyond the typical time). The key is that now there’s better guidance on when to use an add-on prolonged service code versus just using a longer psychotherapy code. Always check the CPT manual or payer policy to see if prolonged time can be billed (and document medical necessity for the extended time).
Collaborative Care and Integration Updates:
As mentioned, 2025 rules expanded who can participate in collaborative care models. This means more types of licensed behavioral health clinicians (like licensed professional counselors and marriage and family therapists) can help deliver CoCM services that are billed under codes 99492–99494. In practical terms, a primary care practice using the CoCM model could hire these professionals as care managers or behavioral health consultants and still bill Medicare for CoCM. Additionally, Medicare increased the reimbursement for general BHI code 99484 by around 12% for 2025, recognizing the value of care coordination. These changes aim to improve access to integrated care by making it financially sustainable.
Expiration of Temporary Telephone Codes:
During 2020–2024, temporary telephone visit codes (CPT 99441, 99442, 99443) were allowed and reimbursed by Medicare as if they were regular visits. As of 2025, those old telephone-specific codes are no longer separately billable for Medicare (they expired with the end of the Public Health Emergency extensions). Instead, providers who conduct brief phone check-ins need to use other codes (like audio-only telehealth using regular E/M or therapy codes with a modifier, or the virtual check-in code G2012 for Medicare). In short, make sure in 2025 you are using the permanent codes and appropriate modifiers for any phone-only services, rather than the discontinued 99441–99443.
| Stay Compliant with 2025 Mental Health CPT Code Changes. We’ve Got You Covered. At MedCare MSO, we handle your billing using the most up-to-date coding standards, so you can focus on care; not claims. |
Real-World Example – Crisis Session:
Imagine a therapist has an emergency session with a patient in crisis that lasts 70 minutes. In 2024, there might have been confusion on how to bill this. With the 2025 clarifications, the correct coding is clear: bill 90839 (crisis psychotherapy, first 60 minutes) plus one unit of +90840 (each additional 30 minutes) to cover the remaining time. The documentation should reflect the patient was in crisis and note the exact session length (e.g. “Crisis counseling from 3:00–4:10 PM, total 70 minutes”). This ensures proper reimbursement for the extended session without undercoding or overcoding. (Source)
CPT Codes for Mental Health Telehealth in 2025
Telehealth has become a vital part of mental health care. The good news for 2025 is that telehealth services for mental health are here to stay. Providers can continue to offer therapy or psychiatry sessions remotely and bill using the same CPT codes as in-person visits. However, there are some special coding rules to follow to get reimbursed for telehealth. Here’s what mental health clinics need to know about telehealth billing:
Use the Same CPT Codes, With Modifiers if Needed:
The CPT codes for a therapy session remain the same whether the session is in-person or via video. For example, a 45-minute video therapy session with an individual client is still coded 90834, and a psychiatric medication management visit might be coded 99213. The key difference is you must indicate it was done via telehealth. To do this, you typically append a telehealth modifier. The most common one is Modifier 95, which signifies “service provided via synchronous telemedicine (real-time audio and video)”. Some payers (like certain Medicaid plans) use Modifier GT, which means essentially the same thing. You place this modifier after the CPT code in your claim (e.g., 90834-95).
Place-of-Service (POS) Codes:
In addition to a modifier, you usually must use a specific place-of-service code to show it was a telehealth encounter. The POS code tells the insurer where the patient was. For telehealth provided at the patient’s home, use POS 10. For telehealth provided when the patient is not at home (e.g., patient is at a clinic or other facility), use POS 02. Using the correct POS code is important for compliance and payment. (By contrast, an in-person office visit is POS 11 for Office.) Some private payers during the pandemic asked providers to continue using POS 11 with a 95 modifier to pay full non-facility rates, but as a rule in 2025, Medicare wants POS 02 or 10 on telehealth claims. Always check the latest guidance of each payer to be sure.
Audio-Only Telehealth:
Not all telehealth involves video. Some patients (especially in mental health) may only have a phone call with their provider. CPT codes for mental health telehealth can still be used for these audio-only services, but you must indicate the audio-only nature. In 2025, Medicare and CPT introduced Modifier 93 to specifically indicate an audio-only telemedicine service. For behavioral health services, Medicare has also used Modifier FQ (for audio-only telehealth for mental health). In practice, these modifiers (93 or FQ) achieve the same goal: they tell the payer that the service was via telephone or other audio means.
Example: A psychologist conducts a 30-minute therapy session by phone because the patient’s internet is down. The psychologist would bill 90832 with modifier 93 (audio-only telehealth) appended. This lets the insurer know it was a real-time service but only by telephone. Important: Not every service is allowed audio-only – but mental health services are an exception where audio-only is permitted (Medicare made this a permanent benefit for behavioral health). Always document why video wasn’t used (e.g., patient lacked access or consented to phone only) to meet any requirements.
Telehealth for Psychiatry (Prescribing and E/M):
Psychiatrists and other prescribers also use telehealth extensively. Psychiatry telehealth CPT codes 2025 usage follows the same rules – you use the normal E/M or psychotherapy codes and append telehealth modifiers. Notably, Medicare in 2025 allows mental health E/M visits (medication management) to be done via video or phone. After the PHE, Congress ensured that psychiatric services can be provided via telehealth to patients at home permanently. If you’re a psychiatrist doing a med check via telehealth, you might bill 99213-95 (for video) or 99213-93 (if it ends up audio-only) along with POS 10 or 02. One special rule: After March 2025, Medicare permanently defined “interactive telecommunications system” to include audio-only for mental health, as long as the provider could use video but the patient cannot or doesn’t consent to video.
This means audio-only psychiatry visits are billable if patient preference/limitations require it. Always use the proper modifier (93 or FQ) in those cases. Also be mindful of controlled substance prescribing via telehealth – there are separate federal rules about an in-person visit requirement for controlled medications (this relates to the Ryan Haight Act), though it has been temporarily waived; check the latest DEA guidelines if prescribing.
Real Example – Telehealth Therapy Claim:
Suppose a clinical social worker conducts a one-hour therapy session via Zoom with a patient who is at home. The appropriate coding would be 90837 (Psychotherapy, 60 min) with modifier 95 (to indicate telehealth) and POS 10 (patient at home). It would look like 90837-95 (POS 10) on the claim form.
The documentation for this telehealth session should include a note that it was conducted via secure video, that the patient consented to telehealth, and perhaps mention the location (patient at home, therapist at office) for clarity. If instead that session was via phone only, it would be 90837-93 (POS 10) to reflect audio-only. By coding this way, the provider will get paid as if it were an in-person 90837 service. (Source)
Documentation and Compliance Tips for 2025
Accurate coding must go hand-in-hand with proper documentation. To stay compliant with medical billing for mental health services rules, providers should pay attention to a few important details. Below are some tips to ensure your documentation and coding practices meet 2025 standards:
Record Session Times and Details:
Because many CPT codes for mental health are time-based, always document the start and end time of the session in the clinical note. For example, write “Session start 3:05 PM, end 3:50 PM (45 minutes)”. This supports the use of a 90834 code. If you just write “45-minute session” without proof, you might face a payer audit questioning if it really met the threshold. In 2025, there’s increased emphasis on noting exact times for psychotherapy codes. This simple step can prevent mental health billing challenges related to time discrepancies.
Include Content Supporting Medical Necessity:
A common reason for claim denials is insufficient documentation of why the therapy or service was needed. Make sure each progress note includes the patient’s current symptoms/issues, what you did in the session (interventions or topics), and the plan or progress. For instance, “Patient reports 3 panic attacks this week (was 5 last week); practiced exposure therapy techniques in session; moderate improvement noted”. This shows the session had a purpose and therapeutic content. Documenting how the service addresses the patient’s diagnosis or treatment plan is crucial for medical billing for behavioral health compliance and justifying the CPT code billed.
Use the Right Modifiers and Codes Together:
Some services require multiple codes and modifiers. If you provide psychotherapy with E/M (medication management) on the same day, remember to add modifier -25 to the E/M code to indicate it’s a separate service in addition to therapy. Also ensure you’re using the correct add-on codes (like 90833, 90836, 90838 for therapy with E/M, or 90840 for crisis add-on). An add-on code should never be billed by itself; it must accompany a primary code. If these coding rules are not followed, you’ll likely get denials.
Know Your Payer Policies:
While CPT is standard, different insurance companies (and Medicare vs Medicaid) can have their own requirements. Some payers might want a specific modifier (like using -GT instead of -95 for telehealth). Others might limit how often certain codes are reimbursed (for example, some insurers only pay for one 90791 evaluation code per patient lifetime, or they might require authorization for prolonged therapy sessions).
Staying up-to-date with each payer’s policies is part of billing compliance. It can be helpful to maintain a cheatsheet of each major payer’s quirks for mental health billing – e.g., which payers accept audio-only, which require prior auth for more than X sessions, etc.
Protect Patient Privacy in Telehealth:
Ensure your telehealth sessions are conducted on a secure platform and that you note patient consent. For example, document “Telehealth session conducted with patient’s consent using HIPAA-compliant video” (Source). This isn’t a coding rule per se, but it’s a legal compliance point. Especially if you’re billing Medicare, they expect you to follow HIPAA and telehealth guidelines. This way, if any questions arise, your documentation shows you took the proper steps.
By following these documentation and coding tips, providers can maintain billing compliance and reduce the risk of audits or denials. In short, code it right and write it down! The combination of correct CPT codes, proper modifiers, and thorough notes is the recipe for successful mental health billing in 2025.
Common Mental Health Billing Challenges and Mistakes
Even experienced therapists and clinics encounter mental health billing challenges. Mistakes in coding and billing can lead to denied claims, reduced revenue, or even compliance issues. Below we outline some common billing errors in mental health and how to avoid them:
Selecting the Wrong Time Code:
This is a frequent error. For example, a therapist conducts a 38-minute session but accidentally bills 90834 (45-minute code) instead of 90832 (30-minute code). This mental health billing mistake can happen if you round up incorrectly or aren’t aware of the CPT time cutoffs. How to avoid: Know the time ranges for each code (e.g. 90832 covers 16–37 minutes, 90834 covers 38–52 minutes, 90837 is 53+ minutes). Always double-check the documented session length before selecting the code. It can help to post a small chart of these ranges at your desk for quick reference.
Not Differentiating E/M vs Psychotherapy Services:
Psychiatrists or psychiatric nurse practitioners who do therapy and med management in one appointment often struggle with this. A common mistake is failing to document the psychotherapy separately from the E/M medical portion. If it’s not clear in the note that both services occurred, an insurer might assume you’re “double billing.” How to avoid: Clearly document the therapy content distinct from the medication management. Use headings in your note like “Therapy Intervention:” vs “Medication Update:”.
Then bill the appropriate E/M code with a -25 modifier and the psychotherapy add-on code (e.g., 99213-25 and 90833). Ensure the psychotherapy time is documented (e.g., “spent 30 minutes on psychotherapy addressing coping skills”). This way, you’ll get paid for both parts of the visit.
Misusing Crisis or Prolonged Service Codes:
CPT 90839 (crisis psychotherapy) and add-on 90840 are meant for actual psychiatric crisis requiring intense therapy intervention, not just a slightly longer session. One common error is using 90839 for any session over an hour even if it wasn’t truly a crisis. Another is failing to meet the time requirement for a prolonged service code (e.g., adding 99354 for an extended session that didn’t actually go beyond the threshold).
How to avoid: Only use 90839 if the patient was in high distress/crisis and the session was primarily crisis management (document the situation to justify it). For prolonged services, remember they typically require you exceed the base time by 15+ minutes beyond the typical duration. In 2024, CPT clarified that prolonged time means time beyond the usual code’s time, not just running late. In 2025, stick to those guidelines and use prolonged codes sparingly and correctly, with start/end times recorded.
Missing or Incorrect Modifiers:
Little modifiers can cause big headaches. Forgetting to put modifier 95 on a telehealth claim, for example, might lead to denial because the insurer thinks it was an in-person service coded with a telehealth POS (mismatch). Or not using modifier 25 when billing an E/M with a therapy code could trigger a denial as duplicate service. How to avoid: Develop a habit or checklist for reviewing claims: If telehealth, add 95; If audio-only, add 93; If E/M+therapy, add 25 to E/M; If distinct services same day, consider 59, etc. It can help to use an electronic health record that flags these or to have a mental health billing provider or biller double-check before submission.
Insufficient Documentation (Leading to Denials):
Sometimes claims are paid initially but later audited. A very common audit finding is “insufficient documentation” – meaning the note didn’t support the service billed. For therapy, this could be a note that simply says “counseled patient, follow up next week” – which isn’t enough to justify a 45-minute psychotherapy code. For psychiatry, it could be not documenting the time spent on psychotherapy during a med check. How to avoid: As mentioned earlier, write progress notes with enough detail.
Make sure the common CPT codes for mental health you bill have matching documentation. If you billed 90837 (60 min), the note should be at least a few paragraphs long and show a substantive session took place (and ideally note the time). For any service, always include who was present (especially for family therapy or group), what was done, why it was needed, and plan for next time. This way, even if you’re audited, you can confidently pass the review.
By being aware of these pitfalls, mental health practitioners can dramatically cut down on billing issues. If you do make a mistake, correct it as soon as possible – for instance, by sending a corrected claim. It’s far better to proactively address common billing errors in mental health than to face repeated denials or repayment demands later. Remember, even small clinics can implement these checks. It might seem like extra work, but it pays off by improving your revenue cycle management and reducing stress in the long run.
Leveraging Mental Health Billing Services for Support
Given the complexity of coding and insurance rules, many practices consider using mental health billing services to help with their claims. These are companies or professionals who specialize in medical billing services for mental health and behavioral health. For a busy therapy practice or a small group clinic, outsourcing billing can free up a lot of time and reduce errors. Here are some points to consider:
Expertise in Behavioral Health Billing:
Specialized behavioral health billing services are familiar with all the nuances we’ve discussed. They know the behavioral health CPT codes, the required modifiers, and the common payer policies. For example, a good service will know that 90837 is allowed by Medicare but some insurance might flag too many 90837s in a row (since it’s the highest-paying therapy code) – and they might advise when to use 90834 vs 90837 appropriately. They also keep up with changes like the 2025 updates, so you don’t have to constantly research new rules – the mental health billing providers will incorporate those for you.
Reducing Errors and Denials:
The best mental health billing services have systems to scrub claims for errors before submission. They might catch that you forgot a modifier or used an outdated code. By catching these, they prevent common mental health billing mistakes from ever reaching insurance, resulting in fewer denials. If a claim is denied, a billing service will typically investigate why and correct it. For instance, if a claim was denied because the insurance needed pre-authorization, the billing company can help obtain that and resubmit. This kind of support can improve your cash flow significantly.
Focus on Patient Care:
Many therapists find billing to be a “nightmare” or at least a major hassle. By hiring a mental health billing company, providers can focus more on seeing clients and less on hold with insurance companies. Solo providers, in particular, often benefit because they may not have staff dedicated to billing. A billing service will handle tasks like verifying patient insurance benefits, submitting claims daily, following up on unpaid claims, and sending patient statements. Essentially, they translate the gibberish of billing into simple terms and handle it behind the scenes.
Choosing a Service:
If you decide to outsource, look for a company experienced in mental and behavioral health specifically – since therapy billing has different quirks (like timed codes and authorization requirements) compared to general medical billing. Read reviews or get referrals for mental health billing companies or providers that colleagues use. Make sure they are up-to-date with 2025 regulations (telehealth, new CPT codes, etc.) and transparent about their fees (usually a percentage of collections or a flat fee per claim).
In summary, whether you handle billing in-house or use a service, understanding CPT codes for mental health and staying compliant is a must in 2025. For many, partnering with mental health billing providers is an effective way to navigate the complex billing landscape while avoiding burnout.
Conclusion
Navigating the world of CPT codes for mental health may seem daunting at first, but with the right knowledge and tools, it becomes a routine part of practice management. In 2025, mental health providers must stay updated on code changes (like new telehealth rules and documentation requirements) to maintain billing compliance and maximize reimbursement.
By using the correct billing codes for mental health services, appending the proper modifiers, and keeping thorough documentation, clinics and solo practitioners can avoid denials and delays. Remember to leverage tables, cheat sheets, or professional services if needed – these resources can simplify the coding process. Most importantly, staying informed about updates (for example, telehealth expansions or new psychiatry telehealth CPT codes 2025 allows for) will ensure you continue to serve your patients without interruption. We hope this complete guide helps demystify CPT coding for mental health.
With careful attention to detail and the guidance provided here, medical billing for mental health services can be manageable and even seamless – allowing you to focus on what you do best, providing care, while knowing your billing is accurate and compliant. For truly accurate, compliant, and stress-free billing, consider outsourcing your mental health billing services to MedCare MSO.
