If you offer mental health services at a practice that accepts insurance, knowing the relevant psychotherapy CPT codes and how to bill them is a must. Short for Current Procedural Terminology®, CPT codes act as a universal “language” that providers and insurers use to communicate about specific services. This aims to streamline claim reporting and increase accuracy and efficiency.
In this article, we will cover some of the most common CPT codes used by therapists.
Note: While this article may serve as a useful starting resource, please be aware that insurance companies can differ in the exact CPT codes, add-ons, and modifiers they accept. Please consult your insurance companies’ manuals, the American Medical Association (AMA), and the Centers for Medicare + Medicaid Services (CMS) for the most up-to-date information. The CMS also offers a Physician Fee Schedule tool to view approximate payout rates for specific codes.
Common CPT Codes
90791: Psychiatric Diagnostic Interview Examination
When do I use CPT code 90791?
Use this code when conducting an initial evaluation of a patient’s mental health, commonly referred to as an intake session. The same provider may be able to repeat this process for the same patient if:
There is an extended break (approximately 6 months) in treatment
The patient requires admission to an inpatient status for a psychiatric illness
A significant change in mental status requiring further assessment occurs (source)
In most cases, you will only bill a client’s first session under 90791, and then utilize the appropriate individual psychotherapy code for subsequent sessions.
90791 is only used for initial evaluations without medical assessment. If a medical assessment is performed, you may use CPT code 90792 or the appropriate evaluation and management (E/M) code. Please consult with your insurance company to determine their preferred process. (source)
Are there time constraints to use 90791?
The CMS requires sessions billed as 90791 to be at least 16 minutes but not more than 90 minutes, with 60 minutes being standard. (source)
What is the payout for 90791?
The payout for this code varies based on the insurer and the client’s plan, and you should always verify this information before submitting a claim. However, this type of session tends to have a higher payout than “normal” follow-up psychotherapy sessions billed as 90832, 90834, or 90837. (source)
90832: Psychotherapy, 30 minutes
When do I use CPT code 90832?
Use this code for individual psychotherapy sessions lasting 30 minutes.
If your session includes medical evaluation and management (E/M) services, you need to use the appropriate E/M code with a psychotherapy add-on code. (source)
Are there time constraints to use 90832?
Sessions must last between 16 and 37 minutes to qualify for this code. Do not bill for psychotherapy services lasting less than 16 minutes. (source)
What is the payout for 90832?
The payout for this code varies based on the insurer and the client’s plan, and you should always verify this information before submitting a claim. However, you can expect to receive a lower payout than you would for a 90834 (45-minute psychotherapy), 90837 (60-minute psychotherapy), or 90791 (intake) session. (source)
90834: Psychotherapy, 45 minutes
When do I use CPT code 90834?
Use this code for individual psychotherapy sessions lasting 45 minutes.
If your session includes medical evaluation and management (E/M) services, you need to use the appropriate E/M code with a psychotherapy add-on code. (source)
Are there time constraints to use 90834?
Sessions must last between 38 and 52 minutes to qualify for this code. (source)
What is the payout for 90834?
The payout for this code varies based on the insurer and the client’s plan, and you should always verify this information before submitting a claim. However, you can expect to receive a lower payout than you would for a 90837 (60-minute psychotherapy) or 90791 (intake) session but a higher payout than you would for a 90832 (30-minute psychotherapy) session. (source)
90837: Psychotherapy, 60 minutes
When do I use CPT code 90837?
Use this code for individual psychotherapy sessions extending beyond the typical 45-minute timeframe.
If your session includes medical evaluation and management (E/M) services, you need to use the appropriate E/M code with a psychotherapy add-on code. (source)
Are there time constraints to use 90837?
Sessions must last between 53 and 60 minutes to qualify for this code. (source)
What is the payout for 90837?
The payout for this code varies based on the insurer and the client’s plan, and you should always verify this information before submitting a claim. However, you can expect to receive a lower payout than you would for a 90791 (intake) session but a higher payout than you would for a 90832 (30-minute psychotherapy) or 90834 (45-minute psychotherapy) session. (source)
90839: Psychotherapy for crisis, first 60 minutes
When do I use CPT code 90839?
Use this code in emergencies with patients who are in high distress and under complex or life-threatening circumstances that demand immediate attention. (source)
Do not report 90839 with CPT codes 90791 or 90792. (source)
Are there time constraints to use 90839?
Sessions must last between 30 and 74 minutes to qualify for this code. (source)
For each additional 30 minutes, CPT code 90840 can be used alongside 90839. Please note that 90840 cannot be billed on its own. (source)
What is the payout for 90839 and 90840, if applicable?
Please refer to the appropriate insurance company for information regarding payment for these codes. However, you can generally expect to receive a higher payout for 90839 than 90840. (source)
90846: Family psychotherapy (without patient), 50 minutes
90847: Family psychotherapy (with patient), 50 minutes
When do I use CPT code 90846 vs. CPT code 90847?
90846 and 90847 refer to types of family psychotherapy. In both instances, the focus of service delivery is on family dynamics or interactions, though treatment is ultimately intended to benefit the patient. (source)
The key difference is that the patient is not present for a 90846 session, while the patient is present for a 90847 session.
Are there time constraints to use 90846 or 90847?
Sessions must last a minimum of 26 minutes to qualify for this code. (source)
What is the payout for 90846 or 90847?
Please refer to the appropriate insurance company for information regarding payment for these codes. However, you can generally expect similar payouts for 90846 and 90847. (source)
Summary
As a therapist, the most common CPT codes you are likely to use are:
90791: Psychiatric Diagnostic Interview Examination
90832: Psychotherapy, 30 minutes
90834: Psychotherapy, 45 minutes
90837: Psychotherapy, 60 minutes
90839: Psychotherapy for crisis, first 60 minutes
90846: Family psychotherapy without the patient present, 50 minutes
90847: Family psychotherapy with the patient present, 50 minutes
While we at Empathic Software hope this article is a helpful starting point, this is not an exhaustive review. Mental health billing is a complex, ever-changing process. If your practice is looking to save time on billing without compromising efficiency, contact us about our in-house mental health billing team.