The Definitive Guide to Mental Health CPT Codes (+Industry Rates) [UPDATED 2018]

2019 CPT Codes Updated:  Please review our additional psychological and neuropsychological testing CPT codes.

If you have a question about billing beyond our guide to mental health CPT codes, you can reach out about our billing service.

CPT (Current Procedural Terminology) is a standardized medical codeset maintained by the AMA.  CPT codes are five digit numeric codes describing everything from surgery to radiology to psychotherapy.

For therapists that are on managed care panels or provide superbills to their clients, knowing your CPT codes is paramount to getting paid in full and avoiding insurance audits.

The amount insurance companies will reimburse depends on a number of different factors (professional credentials, geographic location, etc.), but using the correct CPT Code and add-on code(s) to express the exact service is an important part to the whole process and in ultimately determining your payment!

Errors, accidental or otherwise, will directly impact insurance company’s payment of services.

Downcoding (including less services on the claim than actually provided) will usually mean you get paid less, while upcoding (including more services on the claim than actually provided) can get you in trouble with your managed care panels.

It’s also important to note that it might be tempting to maximize your CPT codes to earn higher reimbursements.

This is highly recommended against and can get you flagged, audited and removed from insurance panels. Even if this is your biller’s error, the therapist is the one who ultimately bears the responsibility and will be the one penalized.

Mental Health CPT Coding for Therapy

CPT coding for psychotherapy doesn’t have to be difficult! There are an overwhelming amount of total CPT Codes (~8,000), however only 24 are specifically designated for psychotherapy and other mental health services.

To make matters even simpler, nearly all therapists will regularly use an even smaller subset of these 24. CPT is a large and dynamic code set that changes year to year, but the psychotherapy codes seldomly change.

The most recent change for psychotherapy codes took place in 2013, previously 1998. In other words, you only really need to learn them once!

Mental Health CPT Add-on Codes

A CPT Add-on Code is a code describing a service performed in in conjunction with a primary service. Many of these add-on codes are associated with a specific CPT Code or a small set of CPT Codes and cannot be used otherwise.

For instance, the CPT Code for interactive complexity (+90785) can be used for a diagnostic (90791, 90792) or a normal psychotherapy session (90832, 90834, 90837) but not a crisis psychotherapy session (90839).

Add-on Codes are identified by a + sign in front of the number, i.e. +90840 is an add-on code for extra time in the case of crisis psychotherapy. On CMS 1500 forms CPT Add-on codes are simply added on a new line.

Mental Health CPT Cheatsheet

The most common CPT Codes used by therapists:

Outpatient Mental Health Therapist Diagnostics, Evaluation, Intake CPT Code:

  • 90791 – Psychiatric Diagnostic Evaluation (usually just one/client is covered)

Outpatient Mental Health CPT Codes:

  • 90832 – Psychotherapy, 30 minutes (16-37 minutes).
  • 90834 – Psychotherapy, 45 minutes (38-52 minutes).
  • 90837 – Psychotherapy, 60 minutes (53 minutes and over).
  • 90846 – Family or couples psychotherapy, without patient present.
  • 90847 – Family or couples psychotherapy, with patient present.
  • 90853 – Group Psychotherapy (not family).
  • 98968 – Telephone therapy (non-psychiatrist) – limit 3 units/hours per application.

Outpatient Mental Health Crisis CPT Codes:

  • 90839 – Psychotherapy for crisis, 60 minutes (30-74 minutes).
  • +90840 – Add-on code for an additional 30 minutes (75 minutes and over). Used in conjunction with 90839.

Other Behavioral Health CPT Codes:

  • +90785 – Interactive Complexity add-on code. Covered below.
  • 90404 – Cigna / MHN EAP CPT Code. These two companies use a unique CPT code for EAP sessions.
  • 96101 – Psychological testing, interpretation and reporting by a psychologist (per Hour)
  • 90880 – Hypnotherapy – limit 10 units/hours per application
  • 90876 – Biofeedback
  • 90849 – Multiple family group psychotherapy

Outpatient Psychiatry Diagnostics / Evaluation / Client Inake CPT Code:

  • 90792 – Psychiatric Diagnostic Evaluation with medical services (usually just one/client is covered)

Outpatient Psychiatry CPT Codes:

  • 99201 – E/M – New Patient Office Visit – 10 Minutes
  • 99202 – E/M – New Patient Office Visit – 20 Minutes
  • 99203 – E/M – New Patient Office Visit – 30 Minutes
  • 99204 – E/M – New Patient Office Visit – 45 Minutes
  • 99205 – E/M – New Patient Office Visit – 60 Minutes
  • 99211 – E/M – Established Patients – 5 Minutes
  • 99212 – E/M – Established Patients – 10 Minutes
  • 99213 – E/M – Established Patients – 15 Minutes
  • 99214 – E/M – Established Patients – 25 Minutes
  • 99215 – E/M – Established Patients – 40 Minutes
  • 99443 – Telephone therapy (psychiatrist), – limit 3 units/hours per application

2019 Mental Health Psychological and Neuropsychological Testing CPT Codes

These codes are only effective January 1st, 2019.

Assessment of Aphasia and Cognitive Performance Testing

  • 96105 – Assessment of aphasia (includes assessment of expressive and receptive speech and language function, language comprehension, speech
    production ability, reading, spelling, writing, e.g., by Boston Diagnostic Aphasia Examination) with interpretation and report, per hour
  • 96125 – Standardized cognitive performance testing (e.g., Ross Information Processing Assessment) per hour of a qualified health care professional’s
    time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report

Developmental/Behavioral Screening and Testing

  • 96110 – Developmental screening (e.g., developmental milestone survey, speech and language delay screen), with scoring and documentation,
    per standardized instrument
  • 96112 – Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory, and/
    or executive functions by standardized developmental instruments when performed), by physician or other qualified health care
    professional, with interpretation and report; first hour

    • + 96113 – Each additional 30 minutes (List separately in addition to code for primary procedure)
  • 96127 – Brief emotional/behavioral assessment (e.g., depression inventory, attention-deficit/hyperactivity disorder [ADHD] scale), with scoring
    and documentation, per standardized instrument

Psychological/Neuropsychological Testing

Neurobehavioral Status Exam

  • 96116 – Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgement, e.g., acquired knowledge, attention, language,
    memory, planning and problem solving, and visual spatial abilities), by physician or other qualified health care professional, both faceto-face
    time with the patient and time interpreting test results and preparing the report; first hour

    • +96121 – Each additional hour (List separately in addition to code for primary procedure)

Test Evaluation Services

  • 96130 – Psychological testing evaluation services by physician or other qualified health care professional, including integration of patient data,
    interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report and interactive
    feedback to the patient, family member(s) or caregiver(s), when performed; first hour

    • +96131 – Each additional hour (List separately in addition to code for primary procedure)
  • 96132 – Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient
    data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report and interactive
    feedback to the patient, family member(s) or caregiver(s), when performed; first hour

    • +96133 – Each additional hour (List separately in addition to code for primary procedure)

Test Administration and Scoring

  • 96136 – Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more
    tests, any method, first 30 minutes

    • +96137 – Each additional 30 minutes (List separately in addition to code for primary procedure)
  • 96138 – Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; first 30 minutes
    • +96139 – Each additional 30 minutes (List separately in addition to code for primary procedure)

Automated Testing and Result

  • 96146 – Psychological or neuropsychological test administration, with single automated instrument via electronic platform, with automated result only


Mental Health Evaluation & Management (E/M) Codes

There are also E/M (evaluation & management) in conjunction with psychotherapy, used by authorized prescribers.

Coding E/M is trickier, harder to document and more vulnerable to audit but usually results in greater reimbursement.

There’s also a series of E/M codes that are used without the psychotherapy component.

For more in-depth coverage on E/M coding for psychotherapy there are some good free webinars released by AACAP on E/M CPT Codes.

  • +90833 – E/M code for 30 minutes of psychiatry (used with 90832).
  • +90836 – E/M code for 45 minutes of psychiatry (used with 90834).
  • +90838 – E/M code for 60 minutes of psychotherapy (used with 90837).

Key Points

  • Psychotherapy must be at least 16 minutes.
  • Time is very important and should be rounded to the nearest CPT Code.
  • Outpatient vs. Inpatient is not important.
  • E/M codes can only be used by prescribers (MD, DO, APN, PA).

Criteria for Interactive Complexity (+90785)

+90785 is one of the new add-on codes in the most recent CPT update in 2013.

This code is used as an umbrella add-on code and can be used for four different criteria. The most common scenarios usually involve children, although this is not necessarily always the case.

Common Examples of Interactive Complexity:

  • The use of play equipment with young children.
  • Interpreters/translators.
  • Involvement of parents with discordant views that complicate the treatment plan.
  • Report of abuse/neglect.

Interactive complexity can be used in conjunction with the primary CPT Codes for diagnostics, psychotherapy, or group therapy and cannot be used for couple/family therapy or crisis codes.

+90785, can be used with: 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90853.

Am I Being Underpaid? Was I Paid the Right Amount?

Here’s typical rates depending on the therapist’s credentials:

Typical Reimbursements by Type of Therapist

Type of Therapist Reimbursement/Session
Social Workers ~$55-60
Marriage Family Therapists ~$60-65
Counselors ~$60-65
Psychologists ~$70-80

These rates can vary significantly therapist to therapist but are good benchmarks for comparison.

How about CPT Codes? How do they affect the rate of reimbursement? This is a difficult and complex calculation, depending on the level of education, location, and license. The AMA has created a code search feature on their website that shows payment based off CPT Code and location.

This information is somewhat incomplete and is based off medicare payments and does not specify a number of other important factors. However, this tool is still very useful to compare the relative value CPT Codes against one another.

Private insurance will be correlated with some deviation from these numbers.

Reimbursement by CPT Code (Three Different Geographies)

Reimbursement (Rest of CA)Reimbursement (Los Angeles)Reimbursement (WA)

Code California Los Angeles Washington
90791 $137.10 $141.17 $132.98
90792 $147.84 $152.16 $143.39
90832 $66.14 $68.03 $64.25
+90833 $67.69 $69.69 $65.70
90834 $87.66 $90.15 $85.18
+90836 $85.71 $88.21 $83.18
90837 $131.28 $134.95 $127.54
+90838 $113.07 $116.42 $109.75
90846 $106.46 $109.51 $103.38
90847 $109.75 $112.82 $106.60
90853 $26.99 $27.83 $26.21
90839 $137.22 $141.04 $133.28
+90840 $65.75 $67.61 $63.89
+90785 $14.67 $15.08 $14.24

Data from AMA Codemanager. These numbers are useful for relative comparison of individual CPT Codes and geography.

Distilled Guide to Mental Health CPT Codes

If you are just starting out or just beginning to deal with managed care, keep it simple.

CPT Codes appear far more complex from the outside looking in. Make a quick cheatsheet.

Don’t worry about memorizing all the CPT Codes (there’s alot!) or even all of the mental health ones. You will likely just use just a few individual codes.

Memorize the relevant codes and use google or other references to find the correct CPT codes for more unique scenarios.

Call to verify eligibility and benefits and make sure those codes will be approved with that client’s coverage.

And if all of that sounds like too much trouble, offload the work to us.  You won’t have to know one CPT code from another to get your billing paid in full.

Additional Resources 


  1. Victoria September 11, 2016 at 3:08 am #

    This was very helpful thank you for taking the time to write this up in one clear concise place and manner.


    • Denny October 21, 2016 at 4:51 am #

      Happy to help Victoria! Glad it was so useful.


  2. J. Mark Manley MFT September 14, 2016 at 4:44 pm #

    Thank you!


    • Denny October 21, 2016 at 4:52 am #

      Of course, Mark.


  3. Anne September 20, 2016 at 2:44 pm #

    Another thank you, much appreciated!


    • Denny October 21, 2016 at 4:54 am #

      Absolutely, Anne, happy we could be of service.


  4. Tina September 22, 2016 at 10:48 am #

    This site was a fantastic one stop website in summing up all of the necessary information in a thorough yet brief description.


    • Denny October 21, 2016 at 4:53 am #

      Tina, your comment made our team’s day. Thank you so much for the kind words. We are trying to be as practical and helpful as possible.


  5. Nita Gamache,, LPC/MHSP September 28, 2016 at 3:52 pm #

    Thank you so much for sharing your insight. Very helpful to me!


    • Denny October 21, 2016 at 4:52 am #

      Glad we could be of service, Nita.


  6. Meredith van ness October 21, 2016 at 4:19 am #

    Great tips. Thanks.


    • Denny October 21, 2016 at 4:52 am #

      Thanks for your comment Meredith. Happy to help.


  7. Austin October 26, 2016 at 7:57 am #

    Denny, what code should be used if a Psychologist is doing an evaluation via the internet? Cpt.99444 is an E/M code used for online eval, but I was wondering if there was a different code assigned to Psych?


    • Denny February 10, 2017 at 6:17 pm #

      Hey Austin,

      You should definitely call the insurance company to approve these services. Tele-therapy and internet therapy are almost never reimbursed from our experience. Definitely call to ask, it will depend on each insurance company and require some very special filing instructions.

      Definitely a tough one! Insurance companies are not keen on remote therapy and rarely grant it unless the patient has no way to get access to a network therapist otherwise (they are disabled, in a very remote area, have no transportation).


  8. Karen December 16, 2016 at 7:23 am #

    Do you know of therapists who offer longer-length sessions, billing a 75-minute session as 90834 + 90832, for example, or a 90-minute session as 90837 + 90832)?


    • Denny December 16, 2016 at 1:11 pm #

      Hi Karen, you would use 90837 and then change the number of units from 1 to 1.5!


      • Ryan June 24, 2018 at 4:54 pm #

        Hi Denny, and in this case how would you describe the service? Would you list “Individual Psychotherapy, 60 minutes” (even for a session that is 75 or 90 minutes) or just “Individual Psychotherapy”?


        • Denny August 8, 2018 at 10:52 am #

          On the CMS form, you should use 90837 for a 60 minute session. The next increment of time would be a 90 minute session that you should bill by increasing the units. Use 1.5 units and 90837.


  9. christine December 21, 2016 at 6:50 am #

    This is so helpful, thank you! How would you bill an initial assessment appointment that was stopped short by the patient after 20 minutes?


    • Denny February 8, 2017 at 5:13 pm #

      We would call up the insurance co and ask specifically about this case, as specific cases like this vary insurance co to insurance co, state to state. If that were totally fruitless, we would bill 90791 with 1 units because the whole hour was allotted for the patient, even if they ended it abruptly. Likewise, if a patient misses a session, they would be charged a cash full fee, or if they arrived late, they would be billed for the whole session.

      It’s important to have a written agreement with your patients / clients about how you are handling payment and walk them through it before beginning your work together. You can check that out at


  10. Suzanne January 26, 2017 at 12:55 pm #

    Thank you so much for this cheat sheet – is it very informative! Is there a minimum time requirement for billing 90791?


    • Denny February 8, 2017 at 5:09 pm #

      We recommend your intake session to be between 45 and 60 minutes.


    • Denny February 8, 2017 at 5:39 pm #

      We recommend at least 45 minutes for an intake session (90791) to be billed with 1 unit. Great question.


    • Rudy October 23, 2017 at 5:48 am #

      The minimum for a 90791, as well as any CPT that is not time indicated already is 15 minutes.


  11. Rose March 27, 2017 at 5:32 am #

    Is there a case for a 90 minute session that isn’t crisis? So a 90837 and 90832 together?


    • Denny March 28, 2017 at 11:10 am #

      I would recommend calling ahead of time and asking, since it’s not a crisis e.g. reactionary. You would bill 90837 with 2 units instead of 1 unit, in terms of billing on your CMS1500 form.

      Thanks Rose!


  12. Willie March 28, 2017 at 7:53 pm #

    I’m having trouble finding the correct billing rate for CPT 90837 here in Los Angeles. The Medi-cal site has the rate at $38., but on this site its much higher.


    • Denny March 29, 2017 at 12:02 pm #

      You will need to contact provider support at Medi-Cal to obtain that information.


  13. Rafael March 29, 2017 at 7:03 am #

    Can +99354 Prolonged service in the office or other outpatient setting be added to 90847 Family psychotherapy? or is it only for individual psychotherapy? I am wondering how best to code couples or family sessions that last longer than 50 minutes. Thanks!


    • Denny March 29, 2017 at 12:02 pm #

      A 90847 session is coded as 45 to 74 minutes for 1 unit.

      For 1.5 units, the session length is 75 to 104 minutes.

      And for 2 units, it’s 105+.

      Then you can think about using a different addon code.


      • Danielle March 23, 2018 at 12:16 pm #

        I am having some problems with +99354. I am billing it with 90837, but I am getting denials from Anthem and was wondering if maybe I need a modifier?


        • Denny June 20, 2018 at 11:51 am #

          To add a longer duration of visit, change the number of units from 1 to 1.5, in this case. That CPT code addon is incompatible with 90837.


  14. Diana April 27, 2017 at 3:52 am #

    This was very helpful. Receiving denials when my physician uses E/M codes 99213-99215 with a mental health diagnosis. This article helped me to be able to explain how to code the E/M code for psychiatry with medication management.


    • Denny May 1, 2017 at 1:21 pm #

      Happy to help Diana! 🙂


  15. Jason May 16, 2017 at 8:19 am #

    Great information! Is the code 90785 to be billed only one time during the course of therapy or can it be billed at each qualifying occurrence?


    • Denny May 16, 2017 at 2:19 pm #

      Hey Jason,

      The short answer is no, because it doesn’t make sense that there would be that level of intensity with every visit.

      You should, though, always bill the most accurate claim possible. So use the code when it best describes the services rendered, and some may or may not be denied, based on that insurance company’s policy. Calling to follow up on these sorts of denials for medical necessity can be beneficial, but the addon code will not generate a very large increase in per appointment revenue, so it might not be worth your time. Some things to consider.

      Take it straight from the APA:

      “Interactive complexity, the new add-on code 90785, refers to specific communications factors that add to the difficulty of service delivery and increase the intensity of effort required of the health care professional in a particular treatment session. This code is intended to
      reflect added intensity, not added time, involved with delivering a service. Practitioners should not assume that they can bill 90785 for each session they have with a “difficult” patient. ”


  16. Erin P. May 18, 2017 at 9:48 am #

    Thank you So Much for this article. We’re having a hard time receiving reimbursements since beginning 2017 (wonder why :P). Each insurance co. is inconsistent with pay-outs; first they Reimburse for 90837, next time they don’t, & this is for the Same Patient. You’d think if an insur. co. paid out for 90837 for ‘patient A’ for one DOS, would be reimbursed again on a claim form with a DOS of 2 weeks later. What’s the deal? Why would Any insur. co. pay out for a regular therapy session (90837, 90834) one week, but not a few weeks later; for the Same Patient? Since this has been the case since the beginning of 2017, your article is really helpful & the quick link resources you put on here are a big help too! So now I love you. Will you marry me Denny? 🙂


    • Denny May 18, 2017 at 10:33 am #

      Hey Erin, your comment made me laugh, thanks!

      That’s a really strange situation, so I would call to ask about what’s going on. If you’re billing it correctly and there aren’t any authorizations or limits for that client, then as long as coverage remains active, you should be reimbursed repeatedly.

      This is one of those situations where folks hire us to help, since we cannot give a great answer without investigating! For help there you can check out our mental heath billing service or call yourself!

      Good luck, what a weird one!!!


  17. Amber May 26, 2017 at 7:06 am #

    CPT code 90863 must now be billed with a primary service code. What other codes can I use to bill this service and it not be an add on?


    • Denny June 20, 2018 at 11:46 am #

      I would strongly recommend against billing this CPT code as it is so ambiguous. Pick a more precise CPT code for less of a billing headache.


  18. Dr. Cheryl Arutt June 9, 2017 at 5:19 pm #

    Has anyone ever actually received reimbursement for +90785 – Interactive Complexity add-on code ? The insurance adjusters at the major health insurance companies (even supervisors) are treating it like a coding error because of the “+” sign and when it is explained to them the major insurers have all, without exception, acted like they had never seen it before. Has anyone used it and gotten it paid? If so, by which company?


    • Denny June 14, 2017 at 2:41 pm #

      We have Dr Arutt. Please do not use the “+” sign when submitting the billing, that’s the reason why it’s not working!


  19. Jayne July 15, 2017 at 4:03 am #

    Thank you for this article. Question, I see these reimbursements are mostrly geared towards therapists, psychologists, SW, can psychiatric nurse practitioners use this?


  20. Dawn August 7, 2017 at 4:10 pm #

    What is the CPT code for billing things like disability paperwork?


  21. Daniel White August 24, 2017 at 11:40 am #

    Can you please help us to bill High Level Inpatient Psychiatric Evaluation taking approximately 90 minutes of time for CNP ?? we are trying to bill 99223 which is getting denied.

    Your response will be highly appreciated.


  22. Theresa August 24, 2017 at 12:29 pm #

    Is the chart referring to licensed clinical social workers where it indicates “social worker”… if so it is really out of line, as our training, responsibility to patients and privileges are as in depth as any of the licensed behavioral health professionals. Ouch!


  23. ariel August 31, 2017 at 4:43 am #

    I am confused by you saying you can bill for multiple units of 90837. You say for a 90 minute session you should code 90837 and bill 1.5 units. It was my understanding that 90837 was for 53 minutes, or longer, essentially into eternity. : P Have you been successful in getting reimbursed for more than one unit or 90837 billed on the same day?


    • E. Plier November 20, 2017 at 8:53 am #

      Hi Ariel :). Depending on the Insurance company (United Health being one that hasn’t been accepting 90837 same day for us), we haven’t been having too much trouble getting a same day reimbursement for 90837.
      We’re in Wisconsin btw, & I’m sure the state you’re billing from makes a difference too. Hope that helps!


  24. Brandi Chiarello October 3, 2017 at 6:36 am #

    90791 – When I work with children I find it is most helpful for the first session to be parents only. Can I bill 90791 for this or must the child be present?


  25. Pamela L. Harris M.D. October 10, 2017 at 7:26 am #

    Hey Denny what a wonderful gift this page has been. Clinicians are always pressed for time. And most want the”best practices” for “best outcomes” but when our time is consumed in the minutiae of coding for proper billing less time can be devoted to giving those who come to us for help our best. So thank you for this unselfish gesture.


  26. Lewis M. YellowRobe October 25, 2017 at 8:51 pm #

    Washington Reimbursement rates are listed in the article.  Are these rates based upon Medicare or private insurance rates?


    • Denny June 20, 2018 at 11:42 am #

      These are Medicare rates as they are the only rates that are reliable on an ongoing basis.


  27. E. Plier November 20, 2017 at 8:48 am #

    Thank you for helping me do my job bro! I’ve been on your email list for over a year now & would have a Lot of reimbursement probs. without you! 🙂


  28. chloe shoes December 20, 2017 at 10:22 am #

    These quoted rates are extremely low reimbursement rates. No one should call these industry standard rates – I am a private practitioner and these rates are less than 50% of standard rates – taking into consideration even of insurance contracts I hold. Insurances need to be confronted. These calculators don’t allow real rates collected (and taxes paid on those full rates should be identifiable pretty easily) to be entered by real providers. You don’t go to your tax accountant, dentist, local pizzeria or college professors and ask for a sliding fee…why should mental health providers be negotiating rates all the time? Stand up to these insurance moguls and demand fair reimbursements.


  29. Jessica Flint February 4, 2018 at 4:13 am #

    I know that most insurance companies do not cover phone sessions. I also don’t take most insurances. For my out-of-network patients, I will supply a statement at the end of each month. On occasion, I will do a phone session. On the statement, I will note the session date and use the CPT code 90837 and then note that this was a phone session. Is this acceptable?


  30. Terri Ogden March 7, 2018 at 12:59 pm #

    I am a sole practitioner in mental health I am licensed mental health counselor. When I submit the claims, I put a procedural code and a place of service code. I have an Anthem client and on our first encounter I billed a 90791 (diagnostic evaluation ) and POS 11.
    They are not paying a claim because they say it needs an “OFFICE CODE”. The plan has a $20 copay and 0 deductible for mental health. They are applying the entire amount to the medical deductible because the calam needs an “Office Code” what is this and why have I never encountered this before? and where on the claim form CMS 1500 would it go?


    • Denny June 20, 2018 at 11:35 am #

      Hey Terri, that is the office place of service code. I would recommend calling and asking. If the claim went to their deductible, it was approved and worked — the client simply has a deductible to pay out from. Sounds like you did things right but simply didn’t exact the deductible payment — I would call to ask and also get a quote for eligibility and benefits. Our guide on that is here:


  31. Trish July 1, 2018 at 4:17 pm #

    Hello I’m a liscence therapist in NYS . Can you tell me what codes I use for an initial therapy /mental health session for private practice? Also, for a 45 minute and 60 minute session. I’m very new to this so I appreciate any insight. Thank you.


    • Denny August 8, 2018 at 10:49 am #

      Happy to help Trish! For your intake use 90791. For a 45 minute session, use 90834 and for a 60 minute session, use 90837!


  32. Smith July 5, 2018 at 10:23 am #

    hello Denny,
    Can you please help me out with the situation where Medicaid of GA denied CPT 90834 for age restriction as this code is covered only for members under 21 years of age. where as we billed the code for patient age of 60 years?


    • Denny August 8, 2018 at 10:56 am #

      This seems to an inaccurate reading of the denial. I would call back and verify EOB information including the exact denial reason. 90834 is a CPT code that has nothing to do with age. Nor would any Medicaid plan be age restricted. I think you should call back and ask them to tell you in plain language why the claims are denied. Then resolve that problem and resubmit corrected claims and/or appeal. We do this sort of work for our providers in our mental health billing service every day, so this type of work is why folks choose us.


  33. Tiffany August 8, 2018 at 8:28 am #

    Hi! I have a question about home based therapy. If one of my therapists was to start doing home based therapy would they bill a different code than the normal 90832-90837? We are just trying to make sure we are billing properly. Any help or advise would be greatly appreciated!


  34. Sarah August 13, 2018 at 7:02 am #

    Do you know if there is a modifier or add on procedure code to bill with an initial and group therapy that were performed on the same day? Thank you!


    • admin September 15, 2018 at 3:15 pm #

      You can use modifier 59 or with Medicare, XE for the same provider with a different service offering or XP for a different provider.


  35. Douglas Van der Heide, M.D., September 27, 2018 at 11:01 am #

    I am a psychiatrist and psychoanalyst and see patients mostly four times a week. Should I be using the GZ542ZZZ code and is there any commercial reimbursement for that? I have used the 90836 but I am definitely seeing patients more often than normal. I want to have my billing reflect the reality of my services but also need to keep the lights on!


    • Denny October 15, 2018 at 2:43 pm #

      Hi Douglas, I don’t know what that ‘code’ refers to exactly but here’s what I suggest for seeing clients more regularly than once a week: 1) call ahead of time to inform their insurance plan of their diagnosis and warranted treatment plan, 2) use the authorization for billing, 3) make sure you continue to seek authorization based on medical necessity directly with their plan. This is something we help out with in our mental health billing service.


  36. ana November 13, 2018 at 11:46 am #

    Is there an update to this for 2018?
    Any changes? Thank you!


    • Denny December 5, 2018 at 10:36 am #

      Yes, changed have been made to psychological and neurospychological / neuropsych testing as well as testing in general. We’ve posted those changes!


  37. Beverly Standley December 5, 2018 at 7:30 am #

    Is there a minimum length of time for group sessions required to bill 90853? Does the group session have to be at least 45 minutes to bill?


    • Denny December 5, 2018 at 10:24 am #

      Great question. We recommend sessions to be at least 60 minutes but each session length ‘recommendation’ is up to each insurance company.



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