What are the CPT billing codes for therapy?

Therapists bill mental health sessions with a short set of CPT codes: 90791 or 90792 for the intake evaluation, 90832, 90834, and 90837 for individual psychotherapy by session length, 90846 and 90847 for family sessions, 90853 for group therapy, 90839 and 90840 for crisis sessions, and the add-on 90785 for interactive complexity. CMS lists all of these in its table of commonly used mental health codes (CMS, Medicare & Mental Health Coverage, MLN1986542, Table 2). Each service pairs with an ICD-10-CM diagnosis code, which APA Services, the American Psychological Association's practice organization, states has been the required code set for billing since October 1, 2015 (APA Services, ICD diagnostic coding).

CPT is a registered trademark of the American Medical Association, which owns and maintains the code set. The code descriptions below are plain-English summaries for orientation. Bill from the current official descriptors.

Which therapy billing codes does a mental health practice use?

CMS groups the codes below under the category names in the middle column (MLN1986542, Table 2).

The middle column uses CMS's category labels. The right-hand column is a plain-English gloss written for this article. For billing, use the AMA's official descriptors.

CMS lists the professionals who can furnish these Medicare-covered services: physicians, clinical psychologists, clinical social workers, nurse practitioners, physician assistants, marriage and family therapists, mental health counselors, and others (MLN1986542, page 12). CMS also states that clinical psychologists, clinical social workers, marriage and family therapists, and mental health counselors can bill the crisis codes (same booklet, Table 2).

What is the difference between 90791 and 90792?

Both codes describe an initial psychiatric diagnostic evaluation, and 90792 is the version that includes a medical assessment. Wisconsin Physicians Service (WPS), a Medicare contractor, defines the evaluation as an integrated assessment of history, mental status, and recommendations, and states that the version with medical services adds physical examination elements (WPS LCD L34616). First Coast Service Options, another Medicare contractor, names 90792 for an evaluation that includes a medical assessment (First Coast A57520).

WPS states that these services must fall within the scope of the provider's state license and clinical practice or education, so confirm your scope before you report 90792 (WPS billing article A57480).

On frequency, WPS states that a diagnostic evaluation can be conducted once, at the onset of an illness or suspected illness. It can be repeated after an extended break in treatment, an inpatient admission, or a significant change in mental status, and WPS treats an extended break as approximately 6 months from the last visit (A57480). WPS also states that the evaluation is reported once per day and cannot be reported with an E/M code by the same provider on the same day (L34616).

What is CPT 90837, and how do 90832 and 90834 differ?

90837 is the individual psychotherapy code for sessions of 53 minutes or more, 90834 covers 38 to 52 minutes, and 90832 covers 16 to 37 minutes. APA Services states that providers can apply the CPT time rule and choose the code closest to the actual session time (APA Services, psychotherapy codes, professional association, third-party).

Two conditions sit on top of the time ranges. WPS states that for psychotherapy sessions lasting longer than 90 minutes, reimbursement requires a report that supports the face-to-face time and the medical necessity (A57480). Confirm that each commercial payer applies the same ranges before you rely on them.

If you prescribe and deliver psychotherapy in the same visit, WPS states you report an E/M service plus the add-on 90833, 90836, or 90838 instead of 90832, 90834, or 90837. The two services must be significant and separately identifiable, and time spent on psychotherapy cannot count toward the E/M service (A57480).

Which codes cover family and group therapy?

Family sessions use 90846 without the patient present and 90847 with the patient present, and APA Services lists both at 50 minutes, reportable once the session reaches 26 minutes (APA Services). Group psychotherapy other than a multiple-family group uses 90853. WPS states that 90846 and 90847 should not be used when the service is taking a family history or providing E/M counseling (A57480).

Couples sessions are billed with the family codes 90846 and 90847. The couples therapy CPT codes guide covers 90846 versus 90847, Medicare's patient-treatment condition, and the documentation a couples note needs.

For group sessions, WPS states that the group must be led by a person authorized by state statute, and that a covered group has a size that can be successfully led, with a maximum of 12 people as its example (L34616). WPS states that interactive complexity can be added to 90853 when medically indicated (A57480).

When do you bill 90839 and 90840 for crisis sessions?

90839 is the principal code for a crisis psychotherapy session and covers the first 60 minutes, and 90840 is the add-on for each additional 30 minutes (APA Services). APA Services states that 90839 requires an urgent assessment, a history of the crisis state, a mental status exam, and a disposition. WPS states that the crisis codes apply when a patient presents in high distress with complex or life-threatening circumstances that require immediate attention (L34616).

The crisis codes stand alone on the claim. WPS states they are reported by themselves and cannot be reported with 90791, 90792, 90832 through 90838, or 90785 (A57480). WPS also states that the crisis codes do not include medical services (L34616).

CMS also lists HCPCS codes G0017 and G0018 for psychotherapy for crisis in an applicable site of service (MLN1986542, Table 2). Check which pair your Medicare contractor expects for your place of service.

What is the interactive complexity add-on 90785?

90785 is an add-on code for specific communication factors that complicate a mental health procedure, and it is reported only alongside a primary code. APA Services lists 90791, 90832, 90834, 90837, and 90853 as the primary codes it pairs with, and states that at least one complicating factor must be present (APA Services). The code cannot be reported solely for translation or interpretation services.

The American Psychiatric Association's interactive complexity guide (revised in 2012) describes four factors (psychiatry.org, Interactive Complexity):

• Managing maladaptive communication among participants that complicates care
• Caregiver emotions or behaviors that interfere with carrying out the treatment plan
• A sentinel event with a mandated report to a third party, such as abuse or neglect reported to a state agency
• Use of play equipment, physical devices, or an interpreter to overcome a barrier to the visit

WPS states that the add-on cannot be reported with crisis codes, or with E/M services when no psychotherapy service is also reported. WPS also states that the add-on does not change the time for the psychotherapy service (A57480, L34616).

Which place of service code do you use for telehealth therapy?

Use POS 10 when the patient is in their home and POS 02 when the patient is anywhere else, according to CMS's telehealth FAQ (updated October 8, 2026) (CMS Telehealth FAQ). CMS states that Medicare has no geographic or place-of-service restrictions on behavioral health telehealth and that two-way, interactive, audio-only technology is permitted for it. CMS marks the code categories in the table above with an asterisk in Table 2 as current Medicare telehealth codes (MLN1986542).

Two dates matter for Medicare mental health telehealth. CMS states that audio-only telehealth in the patient's home is permitted through December 31, 2027, and that an in-person visit requirement for mental health telehealth takes effect after December 31, 2027 (CMS Telehealth FAQ, Q5 and Q6).

For modifiers, CMS's telehealth booklet lists POS 02 and POS 10 for professional claims and ties modifier 95 to hospital-employed therapists billing outpatient therapy on institutional claims (MLN901705). Confirm the modifier each commercial plan expects.

How do you pair a therapy CPT code with an ICD-10 diagnosis?

A therapy claim pairs the CPT code for the service with an ICD-10-CM code for the diagnosis the service treats. APA Services states that ICD-10-CM has been the required code set for billing since October 1, 2015, and that the DSM contains ICD-10-CM codes alongside its diagnostic criteria (APA Services, ICD diagnostic coding). WPS states that diagnosis codes must be coded to the highest level of specificity and that a claim needs a covered diagnosis to establish medical necessity (A57480, L34616).

WPS publishes a covered-diagnosis list for the CPT codes in this article, and the list includes mood, anxiety, trauma-related, and substance-related F-codes (A57480). Check your own payer's list before the first session. APA Services states that the CDC updates ICD codes annually, with changes taking effect October 1, so confirm each code against the current code set. For help finding a code, see how to search and find ICD-10 codes.

What should a therapy note document to support the code?

WPS states that the medical record must indicate the time spent in the psychotherapy encounter and the therapeutic maneuvers applied to produce a therapeutic change (L34616). WPS also states that the record must include a periodic summary of goals, progress toward goals, and an updated treatment plan.

Write each note so a reviewer can match it to the code:

• The diagnosis the session addressed
• Start and end time, which decide between 90832, 90834, and 90837
• The interventions you used
• For 90785, the complicating factor that was present
• For 90839, the urgent assessment, crisis history, mental status exam, and disposition
• For a session over 90 minutes, the face-to-face time and the medical necessity

How do you keep therapy codes, notes, and claims in one place?

Practice Better note templates come in SOAP, ADIME, DAP, BIRP, or a custom format you build yourself (charting), so you can structure a note around the items above. Through the Claim.MD integration, US customers can check eligibility, submit claims, track status, and manage rejections, and any account can create CMS-1500 claims and send superbills to clients (billing and insurance). Practice Better's telehealth page describes accepting session payments and billing insurance from one workflow (telehealth).

For the platform built for therapists, see Practice Better for mental health professionals. To compare billing tools, read how to choose a behavioral health billing software.

Start a free trial of Practice Better to keep your notes, claims, and superbills in one place.

For the basics of CPT codes beyond mental health, see a wellness pro's guide to CPT codes.

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Key takeaways

• CMS lists the evaluation, individual psychotherapy, crisis, family, group, and interactive complexity codes in this article in its table of commonly used mental health codes, and marks those categories as current Medicare telehealth codes.
• APA Services lists the individual psychotherapy time ranges as 16 to 37 minutes for 90832, 38 to 52 minutes for 90834, and 53 minutes or more for 90837, and states that providers choose the code closest to the actual session time.
• APA Services states that 90839 covers the first 60 minutes of crisis psychotherapy and 90840 each additional 30 minutes. WPS states the crisis codes cannot be reported with the evaluation codes, the psychotherapy codes, or 90785.
• APA Services lists 90791, 90832, 90834, 90837, and 90853 as the primary codes 90785 pairs with, and states it cannot be reported solely for translation or interpretation.
• CMS states to use POS 10 for telehealth when the patient is at home and POS 02 for any other location, and APA Services states that ICD-10-CM has been the required diagnosis code set for billing since October 1, 2015.

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