Billing and coding
The 10+ most common CPT codes (and how to use them)
Understand the ins and outs of CPT codes to help make documentation and billing more efficient — and give you more time to focus on other areas of your practice.
December 21, 2023
16 min read
Current Procedural Terminology (CPT) codes are a common numerical language for healthcare professionals to describe the services they provide. As a mental health practitioner, understanding the ins and outs of CPT codes can make documentation and billing more efficient, ultimately saving you time to focus on other areas of your practice.
Depending on your licensure and area of practice, you may find yourself using certain CPT codes more than others. Read on for more info on the most common CPT codes for mental health (and how to use them).
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It’s important to use the code that most accurately reflects the time you spent with the patient to treat their condition, and ensure that documentation for the session supports the chosen code.
90837: 60 minute psychotherapy
If you provide psychotherapy, you’ve probably used CPT code 90837, which represents talk therapy with at least 53 minutes of documented face-to-face time. Time-constrained CPT codes like this one should be documented with an exact start and stop time in your client’s progress notes. As with other psychotherapy codes, a 60-minute session shouldn’t include any related administrative work, such as writing notes or billing. If a client arrives late or leaves early this should be reflected in the exact start and stop time.
90834: 45 minute psychotherapy
CPT code 90834 is similar to 90837, but it represents a shorter session. You can use this code for any face-to-face psychotherapy session between 38-52 minutes. Keep in mind some “hour-long” therapy sessions fit in the upper limit of this code’s 52-minute window. If a client arrives late or leaves early this should be reflected in the exact start and stop time.
90832: 30 minute psychotherapy
Code 90832 is used for a psychotherapy session that includes between 16 and 37 minutes of documented, face-to-face time. Most psychotherapists don’t conduct 30-minute sessions frequently, but may be clinically appropriate for younger clients or other situations where a client has arrived late or left early.
90791: Psychiatric diagnostic evaluation
This CPT code accounts for what you know as your initial client assessment. Code 90791 doesn’t include any medical or mental health treatment; instead, it’s the session where you gather the information needed to make a diagnosis and begin developing a treatment plan. It’s not associated with a time limitation, but most assessment sessions are 45 or 60 minutes. Typically, insurance will allow a clinician to bill 90791 once per year, or when they first see a client who is transitioning from another provider.
90792: Psychiatric diagnostic evaluation (with medical services)
Similar to CPT code 90791, code 90792 encompasses an assessment, diagnosis, and treatment plan; the difference is it also includes medical services. This code is sometimes used by prescribers who may treat the patient by prescribing medication during an initial evaluation. Medical services can also include ordering diagnostic work that helps diagnose someone.
99203–99205 and 99213–99215: E/M codes
Evaluation and management codes, or E/M codes, include services in which a qualified health professional diagnoses and treats an illness or injury. You can use E/M codes based on either time or Medical Decision Making (MDM) when coded without an add-on psychotherapy service. When billing with add-on psychotherapy, you can only use MDM to determine the E/M level. For new patients, use codes 99203-99205, and for existing patients, use 99213-99215.
90833, 90836, and 90838: Individual psychotherapy add-on codes (for use with E/M codes)
CPT codes 90833, 90836, and 90838 are add-on codes that can only be used with E/M codes 99203-99205 (for new patients) and 99213-99215 (for existing patients). You can use these codes when you provide psychotherapy in addition to an evaluation or management appointment. To report both E/M and psychotherapy, the two services must be significant and separately identifiable. For all of these psychotherapy add-on codes, your documentation needs to include exact start and stop times, issues that were addressed, and progress made in the course of psychotherapy treatment.
Codes 90833, 90836, and 90838 are associated with specific times:
- 90833: 16-37 minutes
- 90836: 38-52 minutes
- 90838: 53+ minutes
90846: Family psychotherapy (without patient present)
Code 90846 represents a 50-minute session of psychotherapy where the focus of the intervention is on a family or partnership dynamic, and the identified client isn’t present for the majority of the session. To be reimbursed by most payers for a 90846 session, the session should be treating an identified client’s legitimate clinical diagnosis. It might be used, for example, when you meet with parents of a child or teenager to discuss anxiety management strategies for the child and how the parent can help enact this at home.
90847: Family psychotherapy (with patient present)
Like 90846, code 90847 is used for a 50-minute family psychotherapy session, but with the identified client present with one or more members of their family. To be reimbursed by most payers for a 90847 session, the session should be treating an identified client’s legitimate clinical diagnosis. For instance, in a family therapy session for an adult with obsessive-compulsive disorder, a provider can meet with the client and their spouse to discuss how the diagnosis affects their relationship and how the spouse can provide support at home. 90847 is often used for family therapy with a child as the identified patient, or couples’ therapy.
90785: Interactive complexity
CPT code 90785 is an add-on code that represents psychotherapy sessions that require extra work — not time — due to communication complexity, such as involving a family member in therapy or treating a client who has a mental health symptom that makes communication more difficult. As an add on code, it can only be used with another psychotherapy code, such as 90837, 90834, or 90832. Your documentation for this code should explain which element(s) of interactive complexity were present.
90839 and 90840: Psychotherapy for crisis
CPT codes 90839 and 90840 are used for psychotherapy services during a crisis. To be reimbursed, a provider must be addressing a high-intensity presenting problem that is life-threatening or complex and requires immediate attention for a client in distress. These codes cannot be reported in addition to other psychotherapy codes (90832-90837). Code 90839 is used for the first 30-74 minutes of a crisis session. Code 90840 is an add-on code used for additional 30-minute time blocks after the initial 74 minutes. Code 90839 can only be billed once per day, and 90840 can only be used in conjunction with code 90839.
This document is intended for educational purposes only. It is designed to facilitate compliance with payer requirements and applicable law, but please note that the applicable laws and requirements vary from payer to payer and state to state. Please check with your legal counsel or state licensing board for specific requirements.
Common documentation mistakes that affect billing
Deciding which CPT code to use is only the first step. If you don’t back it up with thorough documentation, you could run into billing headaches.
Don’t forget to include and double check all relevant details about the session, such as the spelling of the patient’s name, the session’s location and length, and so on. Beyond the basics, your documentation must also support the billing code you selected. If, for example, you chose code 90839 or 90840 (psychotherapy for crisis), you must show that the presenting problem was life-threatening or otherwise demanded immediate attention. Failing to do so could lead to rejected or delayed claims.
Misusing modifier codes is another common documentation mistake. Make sure that the codes you’ve selected can be used together, and that you’ve adequately shown why they’re both relevant.
If this seems like a lot to keep track of, Headway can help. With educational resources and templates meant to streamline documentation and billing, Headway supports all of the administrative work that goes into providing good therapeutic care.
Licensing requirements to consider when billing insurance
Only licensed health care providers who are in compliance with relevant state and insurance regulations can use CPT codes to bill insurance. Such requirements ensure that payers are covering only legitimate health care services.
That’s true across the board. But, additionally, some CPT codes can only be used by certain types of providers. A wide range of talk therapists — from licensed clinical social workers to psychologists — commonly use psychotherapy codes like 90837, 90834, and 90834. But codes such as 90792 (psychiatric diagnostic evaluation with medical services) may only be used by advanced practitioners, such as psychiatrists and nurse practitioners.
Build a profitable practice with Headway
Billing insurance is a deceptively complex aspect of offering therapy, from choosing the right CPT code to producing documentation that adequately supports your selection. Headway demystifies the process with tools like progress note templates and billing support, ensuring that claims go through without a hitch — and you get paid as much as you should every two weeks, like clockwork. There’s a reason Headway is home to the largest network of insurance-accepting mental health providers in the U.S. — we make accepting and billing insurance as straightforward as it should be.
This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.
© 2025 Therapymatch, Inc. dba Headway. All rights reserved. No part of this publication may be reproduced without permission.
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