A complete guide to CPT codes for mental health, covering psychotherapy, psychiatric evaluation, collaborative care, and behavioral health integration billing.
Mental health billing runs on a relatively small, specific set of CPT codes - but confusing psychotherapy codes with evaluation and management codes, or misjudging session time, is one of the most common reasons psychiatry and behavioral health claims get denied. This guide walks through the CPT codes for mental health that matter most, how psychiatry billing differs from general psychotherapy billing, and where behavioral health integration fits into the picture.
Psychiatric Diagnostic Evaluation Codes
Every episode of mental health care typically starts with one of two evaluation codes:
- 90791 - Psychiatric diagnostic evaluation without medical services, used by non-prescribing providers like psychologists, LCSWs, and LPCs
- 90792 - Psychiatric diagnostic evaluation with medical services, used by physicians and prescribing providers who also assess medication needs
Neither code has a mandatory minimum time requirement, but thorough documentation of the history, mental status exam, and diagnostic formulation is what supports the claim regardless of how long the visit actually ran.
Psychotherapy CPT Codes
Individual psychotherapy is billed using a timed code series, and session length - not the appointment slot reserved on the calendar - determines which code applies:
- 90832 - Psychotherapy, 30 minutes
- 90834 - Psychotherapy, 45 minutes
- 90837 - Psychotherapy, 60 minutes
CMS instructs providers to report the code closest to the actual session time, and psychotherapy under 16 minutes generally shouldn't be billed using these codes at all. A 52-minute session, for example, still falls within the 90834 range rather than rounding up to 90837.
Add-On Codes for Psychotherapy With Medical Services
When a physician or prescriber provides both an E/M service and psychotherapy on the same day, the psychotherapy portion is billed as an add-on rather than a standalone code: 90833 (30 minutes), 90836 (45 minutes), and 90838 (60 minutes), each paired with the corresponding E/M code (typically 99202–99215).
Group, Family, and Crisis Codes
Beyond individual psychotherapy, several codes cover other common service types. Group psychotherapy uses CPT 90853, family psychotherapy uses 90847 (with the patient present) or 90846 (without), and crisis intervention services are billed under H2011 in 15-minute increments for certain payer and program types.
Collaborative Care and Behavioral Health Integration Codes
This is where mental health billing intersects directly with primary care. CMS reimburses Behavioral Health Integration through a distinct code set, separate from psychotherapy billing entirely:
- 99484 - General BHI services, requiring at least 20 minutes of clinical staff time monthly
- 99492 - Initial psychiatric Collaborative Care Model (CoCM) services, first 70 minutes in the first month
- 99493 - Subsequent CoCM services, first 60 minutes in following months
- 99494 - Add-on code for each additional 30 minutes of CoCM time
These codes are billed under the treating medical provider, with only the Behavioral Health Care Manager's time counting toward the threshold - a structural difference from standard psychotherapy billing that trips up practices new to integrated care models. Circle Health's own complete behavioral health billing codes reference breaks down how these BHI codes pair correctly with ICD-10 diagnoses across different practice settings.
E/M Codes for Psychiatric Medication Management
Psychiatrists and psychiatric nurse practitioners frequently bill standard E/M codes (99202–99215) for medication management visits rather than psychotherapy codes, since these visits center on prescribing and monitoring rather than talk therapy. You can bill these alongside a psychotherapy add-on code when both services occur on the same day and are separately documented.
Telehealth Modifiers for Mental Health Billing
Mental health services are billed extensively via telehealth, and modifier 95 typically applies to synchronous video visits. Payer-specific rules vary on whether telehealth-delivered psychotherapy uses the same codes as in-person sessions or requires additional documentation confirming the platform and connection type used.
Where BHI Fits Into Broader Primary Care Billing
Behavioral Health Integration doesn't exist in isolation from other Medicare programs a practice might be running. Per CMS's own Behavioral Health Integration Services booklet, Medicare pays for care management services addressing any behavioral health condition - including substance use disorders - when delivered by the treating medical provider's care team, not exclusively by a licensed mental health specialist.
This overlap creates real coordination questions for practices layering programs. Principal Care Management billing CPT code confirm that PCM and BHI can be billed together for the same patient in the same month when services are distinct and separately documented, while PCM and standard CCM cannot overlap from the same provider - a distinction worth confirming before billing multiple programs concurrently.
Practical Strategies for Capturing BHI Revenue Correctly
Beyond code selection, the operational side of BHI billing determines whether a practice actually captures the revenue it's entitled to. Practical BHI implementation strategies emphasize routine screening using validated tools like PHQ-9 and GAD-7, clearly defined care team roles, and workflows built specifically to capture billable time accurately as it happens - not reconstructed at month-end.
Software choice matters here too. BHI-specific assessment platforms that connect screening tools directly to billing documentation reduce the gap between clinical work performed and revenue actually captured under 99484 and the CoCM code series.
What's Changing for 2026 and Beyond
CMS has proposed integrating BHI more directly into Advanced Primary Care Management through new add-on G-codes, allowing APCM and BHI/CoCM billing together for the same patient in the same month - a meaningful expansion for practices running population-level primary care alongside behavioral health services.
How Circle Health Fits Into This Picture
Behavioral Health Integration is one of Circle Health's core solutions, and mental health CPT coding sits at the center of making that program financially sustainable. Circle Health pairs AI-powered automation with licensed care managers to capture BHI and CoCM billable time accurately as it happens - screening results, care coordination minutes, and psychiatric consultation time flowing directly into documentation rather than requiring staff to reconstruct it manually at the end of each month.
For physician groups and health systems running BHI alongside CCM, RPM, or PCM for the same patients, this matters beyond a single code family: getting the concurrent-billing rules right (which programs can overlap, which can't) is exactly the kind of cross-program compliance risk Circle Health's platform is built to manage automatically, without adding staff or infrastructure cost to a practice already stretched thin.
Conclusion
Mental health CPT coding splits cleanly into two categories that shouldn't be confused: psychotherapy and evaluation codes billed by behavioral health specialists, and Behavioral Health Integration codes billed by primary care providers running collaborative care programs. Getting session-time documentation right for psychotherapy codes, and understanding how BHI's 99484 and CoCM codes interact with other Medicare programs like PCM and APCM, is what separates clean reimbursement from a steady stream of avoidable denials.
Frequently Asked Questions
1. What is the CPT code for a 45-minute therapy session?
CPT 90834 covers individual psychotherapy of approximately 45 minutes. Session time, not the scheduled appointment length, determines whether 90832, 90834, or 90837 applies to a given claim.
2. What's the difference between CPT 90791 and 90792?
90791 is a psychiatric diagnostic evaluation without medical services, used by non-prescribing providers. 90792 includes medical services and is typically billed by physicians or prescribing providers assessing medication needs.
3. Where can I find a complete mental health CPT codes list?
The official AMA CPT code book is the authoritative source. Treat free, comprehensive lists claiming to be complete and downloadable with caution, since the AMA holds copyright over the full code set.
4. What CPT codes are used for Behavioral Health Integration?
CPT 99484 covers general BHI services requiring 20 minutes of monthly clinical staff time. The Collaborative Care Model uses 99492, 99493, and 99494, tracking the Behavioral Health Care Manager's time specifically.
5. Can BHI be billed alongside other care management programs?
Often, yes. BHI can be billed with Principal Care Management when services are distinct and separately documented, and CMS has proposed allowing BHI/CoCM billing alongside Advanced Primary Care Management as well.
6. Do psychiatry CPT codes differ from general psychotherapy codes?
Not entirely - psychiatrists often use the same 90832–90838 psychotherapy series as other providers, but frequently pair them with E/M codes (99202–99215) for medication management, which non-prescribing therapists don't bill.
7. Are telehealth mental health visits billed differently?
Generally, the same CPT codes apply with modifier 95 added to indicate synchronous video delivery. Payer-specific documentation requirements around platform and connection type can still vary.