Medical Billing Terms C: E/M and Testing CPT Codes 90849 to 99343

E/M CPT codes are the evaluation and management codes psychiatrists use to bill visits by time or medical decision making. This page defines CPT 90849 through 99343, including 99213, 99214, the 96127 to 96139 testing codes and the home-visit codes. Each entry gives a plain definition, why it matters, an example, and an official source. MCM South Medical Billing Service, LLC works only in mental and behavioral health billing.

Last reviewed: October 10, 2026Sources linked at each term

Get a Free Quote Schedule a Consultation

Billing Terms Glossary slide, Terms C: E/M CPT codes - MCM South Medical Billing Service, LLC

Glossary pages

0-9 A BCD E F G H I J K-L M N-O P Q-R S T U-V W-Z

Pages in C

C-1 C-2 C-3 C-4C-5C-6

On this page (23 terms)

CPT 90849
CPT 90853
CPT 96127
CPT 96130
CPT 96131
CPT 96132
CPT 96133
CPT 96136
CPT 96137
CPT 96138
CPT 96139
CPT 99202
CPT 99203
CPT 99204
CPT 99205
CPT 99211
CPT 99212
CPT 99213
CPT 99214
CPT 99215
CPT 99341
CPT 99342
CPT 99343

How to use these E/M CPT codes definitions

Use this page as a quick reference for E/M CPT codes, from CPT 90849 to CPT 99343. Each entry gives a plain definition, why it matters to a mental health practice, and an official source. When a rule changes by payer or state, the entry says so, so confirm E/M CPT codes details with the payer before you bill.

Checklist: put the e/m cpt codes definitions to work

Check the e/m cpt codes entries above before you send a claim that depends on them.
Share this e/m cpt codes page with front-desk and billing staff so everyone works from the same definitions.
When a payer letter mentions e/m cpt codes, find the matching entry and note the date you checked it.
Keep your e/m cpt codes notes next to your payer contracts, because a contract can define a term differently.
Ask the payer to confirm in writing how it applies e/m cpt codes before you change a workflow.
Train new staff on e/m cpt codes first, then move on to the rest of the glossary.
Log any e/m cpt codes question that comes up twice, then add the answer to your billing procedures.
Use the source links under the e/m cpt codes entries to confirm the current rule.
Print the e/m cpt codes entries you use most and keep them at the billing desk.
Review your e/m cpt codes notes each quarter, because payer and CMS rules change.
Mark where e/m cpt codes work differently for psychotherapists and for psychiatrists in your own procedures.
If a e/m cpt codes entry does not match what your payer tells you, follow the payer contract and ask for the answer in writing.
A common e/m cpt codes mistake is relying on an old payer bulletin, so check the date on every source.
Another e/m cpt codes mistake is copying a definition into a policy without citing the source.
Send questions about e/m cpt codes to one billing lead so the answer is shared once.
For e/m cpt codes that affect payment, record the claim number and the name of the payer representative.

Share this page

Search this page

CPT 90849

General (all payers)

Also called 90849; multiple-family group psychotherapy

Definition: CPT 90849 is multiple-family group psychotherapy. CMS lists it separately from 90853, which is group psychotherapy other than of a multiple-family group.
Why it matters: Billed per patient, per session. Ask each payer whether it covers 90849, since many cover 90853 only. Record the date and the start and end time.
Illustrative example: A clinic runs a group for several families of adolescents with eating concerns and bills 90849 for each enrolled patient.

Reference sourceCMS Medicare Learning Network (MLN)American Medical Association (AMA)checked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Behavioral Health Specific Terms

CPT 90853

General (all payers)

Also called 90853; group psychotherapy; group therapy code

Definition: CPT 90853 is group psychotherapy other than of a multiple-family group, reported per patient.
Why it matters: Each patient in the group needs their own note. A Medicare contractor article says the interactive complexity add-on +90785 may be billed with 90853 when medically indicated. Crisis codes are not billed with it. Check the MUE table for unit limits.
Illustrative example: A therapist runs a 60-minute skills group with six patients and bills 90853 once for each patient, each with an individual note.

Reference sourceCMS Coverage Database, Article A57480 (WPS)CMS Medicare Learning Network (MLN)CMS, NCCI Medicare Policy Manual, Chapter XIchecked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Behavioral Health Specific Terms

CPT 96127

General (all payers)

Also called 96127; brief emotional or behavioral assessment; PHQ-9 GAD-7 billing

Definition: CPT 96127 is a brief emotional or behavioral assessment with scoring and documentation, per standardized instrument. Screens such as the PHQ-9 and the GAD-7 are common examples.
Why it matters: It is reported once for each instrument, so units matter. Payers differ on which instruments they accept, whether they pay for it alongside a visit, and how many units they allow.
Illustrative example: A psychiatrist administers a PHQ-9 and a GAD-7 at intake and reports 96127 with two units.

Reference sourceAmerican Medical Association (AMA)checked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Behavioral Health Specific Terms Claims Processing

CPT 96130

General (all payers)

Also called 96130; psychological testing evaluation first hour

Definition: CPT 96130 is a psychological testing evaluation service by a physician or other qualified health care professional for the first hour. It covers integrating patient data, interpreting results, and reporting.
Why it matters: Testing is usually authorization-driven, so confirm prior authorization and unit limits before you schedule. +96131 is added for each additional hour.
Illustrative example: A psychologist spends 90 minutes interpreting results and writing the report and bills 96130 plus one unit of +96131.

Reference sourceAmerican Medical Association (AMA)checked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Behavioral Health Specific Terms

CPT 96131

General (all payers)

Also called +96131; psychological testing evaluation each additional hour

Definition: CPT +96131 is the add-on code for each additional hour of psychological testing evaluation. It is billed only with 96130.
Why it matters: Record the total evaluation time so the additional hour is supported. Never bill it alone.
Illustrative example: A report that takes 2.5 hours is billed as 96130 plus one unit of +96131.

Reference sourceAmerican Medical Association (AMA)checked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Behavioral Health Specific Terms

CPT 96132

General (all payers)

Also called 96132; neuropsychological testing evaluation first hour

Definition: CPT 96132 is a neuropsychological testing evaluation service by a physician or other qualified health care professional for the first hour.
Why it matters: Neuropsychological testing is commonly authorization-driven. +96133 is added for each additional hour.
Illustrative example: A neuropsychologist bills 96132 plus two units of +96133 for a three-hour evaluation and report.

Reference sourceAmerican Medical Association (AMA)checked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Behavioral Health Specific Terms

CPT 96133

General (all payers)

Also called +96133; neuropsychological testing evaluation each additional hour

Definition: CPT +96133 is the add-on code for each additional hour of neuropsychological testing evaluation. It is billed only with 96132.
Why it matters: Document total time. Never bill it alone.
Illustrative example: A neuropsychological evaluation that runs 2 hours is billed as 96132 plus one unit of +96133.

Reference sourceAmerican Medical Association (AMA)checked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Behavioral Health Specific Terms

CPT 96136

General (all payers)

Also called 96136; test administration and scoring by physician or QHP first 30 minutes

Definition: CPT 96136 is psychological or neuropsychological test administration and scoring by a physician or other qualified health care professional, first 30 minutes.
Why it matters: Use it when the clinician personally administers and scores the tests. If a technician does it, the technician codes apply instead. +96137 covers each additional 30 minutes.
Illustrative example: A psychologist administers and scores tests for 75 minutes and bills 96136 plus +96137 units per the payer's rules.

Reference sourceAmerican Medical Association (AMA)checked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Behavioral Health Specific Terms

CPT 96137

General (all payers)

Also called +96137; test administration and scoring by physician or QHP each additional 30 minutes

Definition: CPT +96137 is the add-on code for each additional 30 minutes of test administration and scoring by a physician or other qualified health care professional. It is billed with 96136.
Why it matters: Track minutes carefully. Never bill it alone.
Illustrative example: A 90-minute administration is billed as 96136 plus two units of +96137, if the payer follows the CPT time rules.

Reference sourceAmerican Medical Association (AMA)checked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Behavioral Health Specific Terms

CPT 96138

General (all payers)

Also called 96138; test administration and scoring by technician first 30 minutes

Definition: CPT 96138 is psychological or neuropsychological test administration and scoring by a technician, first 30 minutes.
Why it matters: Payers set rules on technician credentials and supervision. +96139 covers each additional 30 minutes.
Illustrative example: A supervised technician administers tests for 60 minutes and the practice bills 96138 plus +96139.

Reference sourceAmerican Medical Association (AMA)checked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Behavioral Health Specific Terms

CPT 96139

General (all payers)

Also called +96139; test administration and scoring by technician each additional 30 minutes

Definition: CPT +96139 is the add-on code for each additional 30 minutes of test administration and scoring by a technician. It is billed with 96138.
Why it matters: Track minutes and the technician's role. Never bill it alone.
Illustrative example: A technician's 90-minute session is billed as 96138 plus two units of +96139, if the payer follows the CPT time rules.

Reference sourceAmerican Medical Association (AMA)checked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Behavioral Health Specific Terms

CPT 99202

General (all payers)

Also called 99202; new patient office visit straightforward

Definition: CPT 99202 is an office or other outpatient visit for a new patient with straightforward medical decision making. Under the 2021 time table it is selected by 15 to 29 minutes of total time on the date of the encounter.
Why it matters: Prescribers pick an E/M level by medical decision making or by total time on the date of the encounter. A new patient, in CPT terms, has not received professional services from the physician or another physician of the exact same specialty and subspecialty in the same group within the past three years.
Illustrative example: A psychiatrist sees a new patient for a brief, straightforward medication question and bills 99202 based on 20 minutes of total time.

Reference sourceAmerican College of Surgeons, E/M office visit time thresholds AMA, CPT code set overviewchecked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Claims Processing

CPT 99203

General (all payers)

Also called 99203; new patient office visit low complexity

Definition: CPT 99203 is an office or other outpatient visit for a new patient with a low level of medical decision making. Under the 2021 time table it is selected by 30 to 44 minutes of total time on the date of the encounter.
Why it matters: Choose the level by MDM or by total time, not by history and exam alone. Total time counts the physician's or other qualified professional's own face-to-face and non-face-to-face work on the date of service.
Illustrative example: A psychiatrist sees a new patient for a stable condition and bills 99203 after 35 minutes of total time.

Reference sourceAmerican College of Surgeons, E/M office visit time thresholds AMA, CPT code set overviewchecked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Claims Processing

CPT 99204

General (all payers)

Also called 99204; new patient office visit moderate complexity

Definition: CPT 99204 is an office or other outpatient visit for a new patient with a moderate level of medical decision making. Under the 2021 time table it is selected by 45 to 59 minutes of total time on the date of the encounter.
Why it matters: It is a common level for a full psychiatric intake that includes a medical assessment and prescribing decisions. Support the level with either the MDM elements or documented total time.
Illustrative example: A psychiatrist evaluates a new patient, weighs several medication options, and bills 99204 with 50 minutes of documented total time.

Reference sourceAmerican College of Surgeons, E/M office visit time thresholds AMA, CPT code set overviewchecked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Claims Processing

CPT 99205

General (all payers)

Also called 99205; new patient office visit high complexity

Definition: CPT 99205 is an office or other outpatient visit for a new patient with a high level of medical decision making. CMS confirms the base time range as 60 to 74 minutes of total time on the date of the encounter.
Why it matters: Use it only when the documentation shows high-level MDM or the total time supports it. High-level codes draw audit attention.
Illustrative example: A psychiatrist manages a patient with severe symptoms and multiple risk factors and bills 99205 with 65 minutes of documented time.

Reference sourceCMS (Centers for Medicare & Medicaid Services)CMS Medicare Learning Network (MLN)American College of Surgeons, E/M office visit time thresholdschecked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Claims Processing

CPT 99211

General (all payers)

Also called 99211; established patient office visit minimal

Definition: CPT 99211 is an office or other outpatient visit for an established patient that may not require the presence of the physician or other qualified professional. Time and medical decision making do not apply to it.
Why it matters: It is the lowest E/M level. Payers may limit who can bill it and whether it can be billed with other services.
Illustrative example: A nurse checks a patient's blood pressure after a medication change under a prescriber's supervision, and the practice bills 99211 where the payer allows it.

Reference sourceAmerican College of Surgeons, E/M office visit time thresholds AMA, CPT code set overviewchecked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Claims Processing

CPT 99212

General (all payers)

Also called 99212; established patient office visit straightforward

Definition: CPT 99212 is an office or other outpatient visit for an established patient with straightforward medical decision making. Under the 2021 time table it is selected by 10 to 19 minutes of total time on the date of the encounter.
Why it matters: An established patient, in CPT terms, has received professional services from the physician or another physician of the exact same specialty and subspecialty in the same group within the past three years.
Illustrative example: A psychiatrist confirms a stable patient's refill in a 15-minute visit and bills 99212.

Reference sourceAmerican College of Surgeons, E/M office visit time thresholds AMA, CPT code set overviewchecked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Claims Processing

CPT 99213

General (all payers)

Also called 99213; established patient office visit low complexity; most common psychiatry E/M code

Definition: CPT 99213 is an office or other outpatient visit for an established patient that requires a medically appropriate history and/or examination and a low level of medical decision making. Under the 2021 time table it is selected by 20 to 29 minutes of total time on the date of the encounter. Current CPT wording states it as 20 minutes that must be met or exceeded.
Why it matters: It is a common level for a routine psychiatric medication follow-up. Choose the level by medical decision making or by total time on the date of the encounter, and document whichever you use. If you add a psychotherapy add-on (+90833, +90836, +90838), choose the E/M level by medical decision making only and do not count the psychotherapy time toward the E/M.
Illustrative example: A psychiatrist sees an established patient for a stable medication follow-up with a prescription refill and bills 99213. If 25 minutes of psychotherapy are also done, the claim adds +90833.

Reference sourceAmerican College of Surgeons, E/M office visit time thresholds AMA, CPT code set overview CMS Coverage Database, Article A57480 (WPS)checked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Claims Processing

CPT 99214

General (all payers)

Also called 99214; established patient office visit moderate complexity

Definition: CPT 99214 is an office or other outpatient visit for an established patient with a moderate level of medical decision making. Under the 2021 time table it is selected by 30 to 39 minutes of total time on the date of the encounter.
Why it matters: It is a common level when a prescriber manages more than one condition or makes a medication change with monitoring. Support the level with the MDM elements or with documented time.
Illustrative example: A psychiatrist adjusts two medications for an established patient and bills 99214 with 35 minutes of documented time.

Reference sourceAmerican College of Surgeons, E/M office visit time thresholds AMA, CPT code set overviewchecked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Claims Processing

CPT 99215

General (all payers)

Also called 99215; established patient office visit high complexity

Definition: CPT 99215 is an office or other outpatient visit for an established patient with a high level of medical decision making. CMS confirms the base time range as 40 to 54 minutes of total time on the date of the encounter.
Why it matters: Use it only when the record supports high-level MDM or the total time. Higher levels draw audit attention.
Illustrative example: A psychiatrist manages a patient in acute decompensation and bills 99215 with 45 minutes of documented time.

Reference sourceCMS (Centers for Medicare & Medicaid Services)CMS Medicare Learning Network (MLN)American College of Surgeons, E/M office visit time thresholdschecked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Claims Processing

CPT 99341

General (all payers)

Also called 99341; new patient home or residence visit straightforward

Definition: CPT 99341 is a home or residence visit for a new patient with straightforward medical decision making. One published summary shows the time as 15 minutes or more.
Why it matters: Home and residence visits apply to patients seen in their own homes, a group home, a homeless shelter, assisted living, or a residential substance-abuse facility, and not in skilled nursing settings. Use the place of service that matches where the patient is. Do not count travel time.
Illustrative example: A prescriber visits a new patient at home for a straightforward medication check and bills 99341 with POS 12.

Reference sourceSTFM Practice Management Handbook, Home or Residence Visits UTHealth Houston, 2023 Home or Residence Serviceschecked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Claims Processing

CPT 99342

General (all payers)

Also called 99342; new patient home or residence visit low complexity

Definition: CPT 99342 is a home or residence visit for a new patient with a low level of medical decision making. One published summary shows the time as 30 minutes or more.
Why it matters: Level the visit by MDM or time, and do not count travel time. Match the place of service to the patient's location.
Illustrative example: A prescriber sees a new patient in an assisted living apartment for a low-complexity visit and bills 99342.

Reference sourceSTFM Practice Management Handbook, Home or Residence Visits UTHealth Houston, 2023 Home or Residence Serviceschecked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Claims Processing

CPT 99343

General (all payers)

Also called 99343; deleted home visit code; new patient home visit code that no longer exists

Definition: CPT 99343 is a deleted code. The AMA eliminated it on January 1, 2023, when the domiciliary, rest home, and custodial care codes were merged into the home or residence code set. New-patient home visits now use 99341, 99342, 99344 and 99345.
Why it matters: A claim with 99343 will be rejected as an invalid or deleted code, so check billing templates and fee schedules that still list it.
Illustrative example: A practice management system still shows 99343 in an old superbill template, so the billing team replaces it with the correct current code.

Related termsCPT 99342 CPT 99344 CPT Code Superbill

Reference sourceUTHealth Houston, 2023 Home or Residence Serviceschecked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Claims Processing

Quick answer: E/M CPT codes

What is CPT 99214?

CPT 99214 is an office or other outpatient visit for an established patient with a moderate level of medical decision making. Under the 2021 time table it is selected by 30 to 39 minutes of total time on the date of the encounter.

Frequently asked questions: E/M CPT codes

What is CPT 90853?

CPT 90853 is group psychotherapy other than of a multiple-family group, reported per patient. Each patient in the group needs their own note. A Medicare contractor article says the interactive complexity add-on +90785 may be billed with 90853 when medically indicated.

What is CPT 96130?

CPT 96130 is a psychological testing evaluation service by a physician or other qualified health care professional for the first hour. It covers integrating patient data, interpreting results, and reporting.

What is CPT 99213?

CPT 99213 is an office or other outpatient visit for an established patient that requires a medically appropriate history and/or examination and a low level of medical decision making. Under the 2021 time table it is selected by 20 to 29 minutes of total time on the date of the encounter.

Related resources

Where MCM South works

MCM South serves psychotherapists and psychiatrists in ten states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois.

Get a free mental health billing quote

MCM SouthGet a Free Quote