Essential CPT Codes in Behavioral Health

Last Updated on September 12, 2025

There’s a rhythm to behavioral health coding that feels different from any other specialty. Each CPT code is more than a number, it’s a story about what happened in the room: the evaluation that opened a new care plan, the therapy session that ran long because it needed to, or the crisis call that kept someone safe. Coders in this space learn to respect those details because every digit matters. One wrong code can hold up payment, disrupt care, and frustrate providers. One accurate claim keeps the system moving smoothly.

Behavioral health is also one of the fastest-growing specialties. According to the National Institute of Mental Health (NIMH), 1 in 5 U.S. adults, about 57.8 million people, live with mental illness each year. Telehealth has expanded access even more, with behavioral health making up nearly half of all telehealth visits since the pandemic. That means coders have a bigger role than ever, keeping pace with demand, payer scrutiny, and the administrative work that follows when AR piles up.

This breakdown explores the most essential CPT codes used in behavioral health coding. Each section includes context, code explanations, and practical coding notes so even a newcomer can build confidence.

Psychiatric Diagnostic Evaluations: Laying the Foundation

Every treatment plan starts with a diagnostic evaluation. This is where the provider documents a patient’s history, current symptoms, and assessment. For coders, the choice here sets the tone for reimbursement. If it’s coded incorrectly, AR teams often end up chasing payments later.

• 90791 – Psychiatric diagnostic evaluation (without medical services)
  Used when the evaluation includes interviews, history-taking, and assessments but does not involve prescribing or adjusting medications.
• 90792 – Psychiatric diagnostic evaluation (with medical services)
  Applied when the provider includes medical decision-making, such as prescribing psychiatric medication, alongside the evaluation.

Coding insight: These two codes often confuse beginners. The difference isn’t about who delivers the service but what’s documented. If medical decision-making isn’t shown, 90791 is the correct code. Coders who clarify this up front reduce downstream AR delays.

Psychotherapy Codes: Time Is Everything

Psychotherapy sessions form the backbone of behavioral health. Unlike surgical codes that describe a procedure, these codes live and die by time documentation. Payers know these codes drive volume, which is why audits are common, especially around 90837, the 60-minute session. Scheduling also plays a big role here: overbooking therapy sessions without accurate time logs often leads to discrepancies that slow reimbursement.

• 90832 – Psychotherapy, 30 minutes (16–37 minutes)
  Short, focused sessions often used for follow-ups or check-ins.
• 90834 – Psychotherapy, 45 minutes (38–52 minutes)
  The standard therapy length in most outpatient settings.
• 90837 – Psychotherapy, 60 minutes (53+ minutes)
  Reserved for extended sessions. This code attracts scrutiny if billed too often without clear medical necessity.
• 90838 – Psychotherapy add-on with E/M service
  Used when psychotherapy is provided on the same day as a psychiatric evaluation and management service.

Coding insight: A 2024 MGMA survey showed that time-based documentation errors were among the top denial reasons in behavioral health. When providers clearly log session times, coders not only prevent rejections but also spare AR teams from lengthy follow-up work.

Crisis Psychotherapy: Coding the Urgent Moments

Crisis psychotherapy captures those urgent sessions where stability is the immediate goal. Coders need to treat these differently, because payers require proof that this was a crisis—not just a longer therapy session. Timely scheduling here is also critical, as patients in crisis often need to be seen outside of normal appointment grids.

• 90839 – Crisis psychotherapy, first 60 minutes
  Used when the provider delivers immediate, intensive psychotherapy for a crisis.
• 90840 – Crisis psychotherapy, each additional 30 minutes
  Add-on code for extended crisis interventions.

Coding insight: Always capture start and stop times, presenting problems, and interventions in the documentation. Doing so not only secures correct payment but also prevents AR backlogs from payers questioning “crisis” claims.

Family and Group Psychotherapy: Beyond the Individual

Behavioral health often extends beyond individual therapy. Family dynamics, caregiver involvement, and group support all play roles in patient progress. Coders must distinguish who was present, since payers reimburse differently based on patient vs. family participation. Correct scheduling also matters, especially for group sessions where patient counts and attendance need to be tracked carefully.

• 90846 – Family psychotherapy, without patient present
  Used when therapy is provided to family members without the patient.
• 90847 – Family psychotherapy, with patient present
  Covers sessions where family and patient participate together.
• 90849 – Multiple-family group psychotherapy
  Less common but used when several families engage in structured therapy together.
• 90853 – Group psychotherapy (non-family)
  The standard group therapy code for unrelated patients.

Coding insight: Documentation should list participants, therapeutic techniques, and session goals. Missing these details can push claims into AR as payers request more information.

Telehealth in Behavioral Health: The New Normal

Telehealth has transformed access to care, particularly for mental health. But with growth comes complexity, payers now demand precise coding for modality, platform, and place of service. AR teams report that telehealth claims are among the most common to face delays when modifiers are missing.

• Modifier 95 – Synchronous telehealth (audio + video)
• Modifier FQ – Audio-only telehealth
• Modifier FR – Hybrid telehealth encounters

Coding insight: Behavioral health accounts for the largest share of telehealth visits across all specialties. Using the correct modifier upfront reduces payer rejections and keeps AR manageable.

Collaborative Care and Integration: Tracking the Team Effort

Behavioral health coding isn’t just about individual sessions anymore. Collaborative care codes reimburse integrated models where primary care and behavioral health providers coordinate treatment. These are time-based, monthly codes that require precision. If time isn’t logged consistently, AR delays become inevitable because payers need cumulative proof of service.

• 99484 – General behavioral health integration (20 minutes/month)
• 99492 – Initial collaborative care, 70 minutes/month
• 99493 – Subsequent collaborative care, 60 minutes/month
• 99494 – Add-on for each additional 30 minutes
• G2086–G2088 – CMS-specific collaborative care codes

Coding insight: These codes remain underused, but studies show collaborative care reduces hospitalizations and saves $6 for every $1 spent (Milliman). Coders who track collaborative minutes accurately prevent AR teams from dealing with payer disputes.

Documentation Habits That Protect Coders

Behavioral health coders quickly learn that strong documentation is their best defense. It not only supports clean claims but also protects providers in audits.

Key practices include:

• Linking ICD-10 codes like F32 (major depression), F33 (recurrent depression), F41 (anxiety), F43 (stress-related disorders) to establish medical necessity.
• Documenting exact start and stop times for psychotherapy.
• Capturing family or group participants in session notes.
• Applying telehealth modifiers consistently.
• Coordinating with scheduling teams to avoid mismatches between patient calendars and billed codes.

Coding insight: Practices that integrate scheduling, coding, and AR tracking into one workflow see smoother revenue cycles and fewer payer delays.

Behavioral health coding rewards precision. Each digit tells payers what service was delivered, why it mattered, and why it should be reimbursed. For coders, mastering these codes isn’t just about compliance, it’s about ensuring patients continue receiving uninterrupted care, while providers avoid revenue bottlenecks in AR.