Resources · Billing code guide
Mental Health Billing Codes: The Complete CPT, HCPCS, Place of Service and Telehealth Guide
Every code a psychotherapist or psychiatrist bills, how long the service must run, which modifier and place of service go on the claim, and what the note must show. Checked against CMS.gov on 10/1/26.
What are mental health billing codes? They are the numbers on a claim that tell an insurer what you did (CPT or HCPCS code), how (modifier), where (place of service) and for how long. This guide covers psychotherapy, E/M, testing, HCPCS, place of service, modifiers and telehealth for psychotherapists and psychiatrists. Psychiatrist-only items are marked Prescribers.
Use this page as a reference for the mental health billing codes therapists and psychiatrists bill, then follow the links to each code group.
Psychotherapy and psychiatric CPT codes: time ranges at a glance
Non-E/M codes describe services that are not office visits. Psychotherapists and psychiatrists both use them. Full tables are on the Non-E/M code guide.
These are the core mental health billing codes for therapy visits, listed by session length.
| Code | Service | Time | Notes |
|---|---|---|---|
| 90791 | Psychiatric diagnostic evaluation, no medical services | Not a timed code | Contractors expect session length in the note. |
| 90792 | Psychiatric diagnostic evaluation, with medical services | Not a timed code | Prescribers |
| 90832 | Psychotherapy | 16 to 37 minutes | Face-to-face time. |
| 90834 | Psychotherapy | 38 to 52 minutes | |
| 90837 | Psychotherapy | 53 minutes or more | |
| +90833 / +90836 / +90838 | Psychotherapy add-on to an E/M | 16–37 / 38–52 / 53+ minutes | Time excludes E/M time. Prescribers |
| 90839 / +90840 | Crisis psychotherapy | CPT first block 30 to 74 minutes; +90840 each additional 30 | Time need not be continuous. CMS words 90839 as “first 60 minutes”; confirm payer threshold. |
| 90846 / 90847 | Family psychotherapy without / with patient | No range set by CPT or CMS | Ask each payer for its minimum. |
| 90853 | Group psychotherapy | No range set by CPT or CMS | Contractors describe about 45 to 60 minutes. |
| +90785 | Interactive complexity | Add-on, not timed | Document the adaptation you made. |
Sources: contractor articles A57520 and A56937; CMS crisis psychotherapy page; MLN1986542, March 2026.
Record start time, end time and total minutes in every timed note, for every payer. The time decides which psychotherapy code you bill, and one habit works for every insurer.
E/M and home visit codes for psychiatrists: time and documentation
E/M means evaluation and management, the office-visit family prescribers bill. Pick the level by medical decision making (MDM) or by total time, and note which you used.
For psychiatrists, these mental health billing codes add time-based E/M and add-on code rules.
| Code | Patient | Time |
|---|---|---|
| 99202 / 99203 / 99204 / 99205 | New, office | 15+ / 30+ / 45+ / 60–74 minutes |
| 99212 / 99213 / 99214 / 99215 | Established, office | 10+ / 20+ / 30+ / 40–54 minutes |
| 99341 / 99342 / 99344 / 99345 | New, home or residence | 15+ / 30+ / 60+ / 75+ minutes |
| 99347 / 99348 / 99349 / 99350 | Established, home or residence | 20+ / 30+ / 40+ / 60+ minutes |
CMS confirms the 99205 and 99215 ranges in Table 3 of MLN006764. Other levels: E/M and home visit guide. 99343 no longer exists.
- Prolonged office visits: Medicare uses G2212, not CPT 99417. 99205 plus one G2212 is 89 to 103 minutes; 99215 plus one G2212 is 69 to 83 minutes.
- G2211: attaches to E/M, not psychotherapy codes. Since 1/1/2026 it also attaches to home or residence E/M (Transmittal 13753).
- E/M with psychotherapy: bill both and keep the two times separate. First Coast: “The total time does not include the E/M time.”
Psychological and neuropsychological testing codes: 96130 to 96139
Testing codes pay for the test, the scoring and the report, not for therapy. Most payers want prior authorization and set unit limits, so check before you schedule.
Testing codes are billed by time, and the rules differ from the other mental health billing codes in this guide.
| Code | Service | Time unit |
|---|---|---|
| 96130 / +96131 | Psychological testing evaluation (interpret and report) | First hour / each additional hour |
| 96132 / +96133 | Neuropsychological testing evaluation | First hour / each additional hour |
| 96136 / +96137 | Test administration and scoring, physician or QHP | First 30 minutes / each additional 30 |
| 96138 / +96139 | Test administration and scoring, technician | First 30 minutes / each additional 30 |
| 96116 / +96121 | Neurobehavioral status exam | First hour / each additional hour |
| 96127 | Brief emotional or behavioral assessment (PHQ-9, GAD-7) | Per instrument |
QHP means qualified health care professional. “+” codes are add-ons and never bill alone.
- Supervision: general supervision by a physician or clinical psychologist, or by a nurse practitioner, clinical nurse specialist, physician assistant, CRNA or nurse-midwife (42 CFR 410.32).
- Technician time: 96138/96139 bill on hours face-to-face. Different tests the same day can be billed together (CMS testing FAQ).
- Do not report 96116/96121 with 90791 or 90792, or time that duplicates the diagnostic interview (NCCI chapter 11).
HCPCS codes for mental health: Medicare G-codes and Medicaid H-codes
HCPCS Level II codes cover services CPT does not. Medicare uses G-codes. State Medicaid programs define their own H-codes and T-codes.
HCPCS (Healthcare Common Procedure Coding System) codes sit alongside CPT mental health billing codes, mostly on Medicare and Medicaid claims.
Medicare (CMS)
| Code | What it is | Key rule |
|---|---|---|
| G0444 | Annual depression screening | Once per 12 months, 11 full months between (Transmittal 2431). Covered “when staff-assisted depression care supports” are in place, a primary care setup. |
| G0442 / G0443 | Alcohol misuse screening / brief counseling | 15 minutes each. G0442 once a year; G0443 up to four a year (Transmittal 2433). |
| G0396 / G0397 | Structured screening and brief intervention | 15–30 minutes / over 30. Not billed separately with E/M, diagnostic or psychotherapy codes the same day. |
| G2211 / G2212 | E/M complexity add-on / prolonged service | See Section 2. |
| G0560 | Safety planning interventions | Time-based, 20-minute units, personally performed by the billing practitioner. |
| 99492–99494, 99484, G0323 | Collaborative care and behavioral health integration | Monthly time thresholds in MLN909432; patient consent. |
Commercial and Medicaid payers may want CPT 99408/99409 instead of G0396/G0397. Ask the payer.
Medicaid
Each state decides which H-codes and T-codes it pays and what it requires in the record. The same code can mean different services in different states. We list only rows confirmed against a state Medicaid source: Medicaid HCPCS guide.
Place of service codes for mental health billing
A place of service (POS) code is the two-digit number that says where the patient was during the service. It changes payment. CMS keeps the master list (CMS POS Code Set, modified 2/17/2026).
A place of service code goes on every claim, alongside the mental health billing codes above.
| POS | CMS name | Medicare rate | When you see it |
|---|---|---|---|
| 02 | Telehealth Provided Other than in Patient’s Home | Facility | Patient at work or another location |
| 10 | Telehealth Provided in Patient’s Home | Non-facility | Patient at home |
| 11 | Office | Non-facility | In-person at your office |
| 12 | Home | Non-facility | You go to the patient’s home |
| 13 | Assisted Living Facility | Non-facility | Home visit in assisted living |
| 14 | Group Home | Non-facility | Home visit in a group home |
| 33 | Custodial Care Facility | Non-facility | Home visit in custodial care |
| 53 | Community Mental Health Center | Facility | Service in a CMHC |
| 55 | Residential Substance Abuse Treatment Facility | Non-facility | Residential treatment |
Rates: Claims Processing Manual ch. 12, s. 20.4.2 and Transmittal R12671: “The payment rate for POS 02 is the facility payment rate (F); the payment rate for POS 10 is the non-facility rate (NF).” See the Place of service guide and the full POS list.
Modifiers for mental health claims
A modifier is a two-character add-on that changes how a payer reads the code. All 17 are on the modifiers guide.
Modifiers adjust the mental health billing codes on a claim; they do not replace them.
| Modifier | Meaning (CMS wording) | Use it when | Layer |
|---|---|---|---|
| 25 | Significant, separately identifiable E/M by the same practitioner on the same day as a procedure or other service | Prescriber bills E/M plus another service | CPT / NCCI |
| 59, XE, XP, XS, XU | Distinct procedural service and the four X-modifiers | A payer edit bundles two separate services. Never on an E/M. | CPT / NCCI |
| 95 | Synchronous telemedicine, real-time audio and video | Medicare video telehealth | Medicare |
| 93 | Synchronous telemedicine, telephone or audio-only | Medicare audio-only telehealth | Medicare |
| GT | Via interactive audio and video | Medicare: critical access hospital Method II institutional claims only. Some state Medicaid programs require it (Georgia). | Medicare and state |
| GQ | Asynchronous | Store-and-forward telehealth | Medicare |
| AH / AJ | Clinical psychologist / clinical social worker | Medicare no longer requires them; some commercial payers do | Medicare / payer |
| HN, HO, HP, HQ | Education-level and group modifiers | Defined by each state Medicaid program or payer. Never assume the meaning. | State |
Telehealth billing for mental health: what the primary sources say
Telehealth is a large share of how mental health care is delivered, so this section follows the primary sources: CMS, the Drug Enforcement Administration (DEA) and each state’s Medicaid agency. Every item shows its source. Checked 10/1/26.
Telehealth visits generally use the same mental health billing codes as in-person visits, with different place of service and modifier rules.
Medicare (CMS)
| Topic | Current rule | Source |
|---|---|---|
| Where the patient can be | Through December 31, 2027, Medicare telehealth can be received “anywhere in the United States.” For behavioral health, the Consolidated Appropriations Act, 2021 “permanently removed geographic and place of service restrictions.” | CMS Telehealth FAQ (updated 2/26/26) |
| Audio-only | Allowed through December 31, 2027. | Same FAQ |
| In-person visit | Effective after December 31, 2027: an in-person visit within 6 months before the first mental health telehealth service and within 12 months of each one. Patients who began on or before 12/31/2027: one in-person visit every 12 months. | Same FAQ |
| Place of service and modifier | POS 02 or 10 with modifier 95 (video) or 93 (audio-only). The modifier does not change the rate; POS 02 pays facility, POS 10 non-facility. | Transmittal R12671 |
| Rural health clinics and FQHCs | From 10/1/2026 (implemented 10/5/2026), bill the individual code with 93 or 95 instead of G2025. | CMS MM14468 |
| Home address | Practitioners with a physical practice location who telehealth from home are “not required to report their home address.” | CMS Telehealth FAQ |
| Supervision | Real-time audio-video “virtual presence” counts for direct supervision of many services. Audio-only does not. | CMS Telehealth FAQ |
Prescribers: controlled substances by telehealth
Medicaid: state telehealth rules
State Medicaid policy differs from Medicare and from every other state. Fee-for-service rules may not be what you bill under if the state runs managed care. These states are confirmed from the state’s own document.
| State | Source and date | Modifiers and POS | Record requirements |
|---|---|---|---|
| New York | Telehealth Policy Manual v2026-V2, eff. 7/29/2026 | 95 or GT video; 93 or FQ audio-only; POS 02 or 10. OMH providers use 93 for audio-only from 7/1/2025. | Informed consent in chart, patient location, modality. Managed care plans must cover audio-only. |
| Texas | TMHP Telecommunication Services Handbook, Oct. 2026 | 95 video; FQ audio-only behavioral health (93 other audio-only). | Verbal consent allowed for audio-only behavioral health if documented. Managed care plans cannot deny solely because it was remote. |
| Georgia | Telehealth Guidance, 4/1/2026 (fee-for-service) | GT with POS 02 or 10; 93 may be appended for audio-only. | Written consent. Records include “start and stop times,” signature, credentials, originating and distant site. Care management organizations may bill differently. |
| Massachusetts | All Provider Bulletin 379, Oct. 2023 | 95 video; 93 or FQ audio-only; POS 02 or 10. GT on institutional claims. | Note telehealth in the record; record patient location; privacy notice. Applies to fee-for-service and managed care. |
| Colorado | HCPF Telemedicine Billing Manual (page revised 10/20/2022, later items added) | 95 video; 93 or FQ audio-only; POS 02 or 10. | Member consent, verbal or written, for each subsequent visit. |
Commercial payers and state law
Commercial payers set their own modifier, place of service and audio-only rules, and state telehealth laws differ. Read each payer’s behavioral health telehealth policy.
Telehealth documentation checklist
- Patient location (street address or “home”) and provider location.
- Audio-video or audio-only, and the platform.
- Consent, where the state or payer asks for it.
- Start time, end time and total minutes. Telehealth changes the modifier and place of service on the claim. It does not change the time range.
- The same clinical content you would write for an in-person visit.
- HIPAA: use a platform you have a business associate agreement with.
Sources and what to recheck
Checked 10/1/26. Sources are linked where they are cited. Recheck these first:
Every statement about mental health billing codes on this page was checked against CMS.gov and the sources below.
- Medicare telehealth dates (12/31/2027) and the in-person requirement: CMS Telehealth FAQ.
- DEA controlled-substance telemedicine status (12/31/2026).
- Your Medicare contractor’s psychotherapy and testing articles.
- NCCI edits and unit limits (a new table takes effect 10/1/2026).
- Your state Medicaid telehealth page and each commercial payer’s policy.
MCM South provides operational and compliance guidance for billing, not legal or clinical advice. Talk to an attorney or compliance officer where the exposure is real.
Mental health billing codes: frequently asked questions
How long does a session have to be to bill 90837?
90837 is for psychotherapy of 53 minutes or more. 90834 covers 38 to 52 minutes and 90832 covers 16 to 37. Medicare contractors say to choose the code closest to the actual time and not to report psychotherapy of less than 16 minutes. Write the start time, end time and total minutes in the note so the time on the page matches the code.
What place of service do I use for telehealth when the patient is at home?
Use POS 10 when the patient is at home and POS 02 when the patient is somewhere else. Medicare pays POS 10 at the non-facility rate and POS 02 at the facility rate. Medicaid and commercial payers can differ, so check each one.
Which modifier does Medicare want for telehealth?
Use 95 for real-time video and 93 for audio-only. GT applies on Medicare only to critical access hospital Method II institutional claims. Some state Medicaid programs still require GT, so follow the state manual.
Is audio-only telehealth still covered by Medicare for mental health?
Yes. CMS says audio-only in the home is allowed through December 31, 2027. After that date an in-person visit is required for mental health telehealth, with a one-visit-per-12-months rule for patients who started on or before December 31, 2027.
Can psychiatrists prescribe controlled substances by telehealth in 2026?
The DEA and HHS extended the flexibilities for Schedule II to V prescribing without an in-person exam through December 31, 2026. Confirm what DEA has done before 1/1/2027, and use EPCS-certified software.
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