The health care providers in the United States are instructed to use certain codes to describe the care provided, and often while filing insurance claims. Current Procedural Terminology (CPT Codes) are a five-digit code set and maintained by the American Medical Association (AMA). These psychotherapy billing codes are used by medical practitioners to document mental health billing, such as therapy sessions, psychiatric evaluations, and much more.
According to the latest changes and updates, thousands of CPT codes are widely regulated in the medical world of the United States. However, the chronic care management observes around two dozen codes.
This blog features mental health coding guidelines and key CPT codes that are used by psychiatrists, including key compliances, documentation rules, and the updated Telehealth changes in 2026.
Why CPT Codes Matter in Mental Health Billing
The American Medical Association describes CPT as essential codes used by psychiatrists to determine the provided services. It is emphasized by the authorities to use the accurate code to claim the payment, making it easier for insurance billing for therapists. The authorities observe CPT codes for mental health billing for diagnostics, medical, and surgical reporting. The observations in mental health and physical health billings are conducted in a similar fashion.
Importance Of Accurate CPT Codes
CPT codes allow everyone involved in the process (From patient to Service Providers) to speak the same language to determine the diagnosis and services provided. For example, if an individual has been provided with a 35-minute therapy session, everyone involved in the process may determine the service with its dedicated CPT code 90834.
Using the right CPT code ensures accurate mental health reimbursement by eliminating risks of claim denials and inaccurate audits. It allows the authorities involved to streamline practice management and helps to stay compliant with insurance and regulatory standards.
Essential CPT Codes for Therapy
While the medicine industry practices more than a thousand CPT codes, psychotherapists in the United States use around 20-24 common codes for mental health billing. These codes cover further specifications such as evaluation, individual & group psychotherapy, and Crisis Psychotherapy. In addition to this, there are separate codes for Behavioral Health Integration (BHI) and Collaborative Care Management (CoCM).
The most commonly used psychotherapy billing codes are as follows:
Evaluation Codes:
- 90791: This CPT code is used to determine the psychiatric initial diagnostic evaluation without performing any medical service.
- 90792: Unlike the previous code, CPT Code 90792 refers to the psychiatric initial diagnostic evaluation while prescribing medications.
Individual Psychotherapy Codes:
The following CPT codes for therapy are categorized by time, called Time-Based CPT codes. It is used when the duration of a service determines the code. In this case, the psychiatrists or mental health billing authorities identify bills based on the exceeded duration of their services.
- 90832: The following CPT code refers to an individual face-to-face psychotherapy session of 16-37 minutes.
- 90834: This CPT code is used for a brief face-to-face psychotherapy session of 38-52 minutes
- 90837: The following code is used by medical health billing authorities for a brief face-to-face psychotherapy session of 53 minutes or more.
Group Psychotherapy Codes
- 90846: This code refers to the family or couple psychotherapy session without the presence of the patient.
- 90847: In contrast, CPT Code 90847 refers to the family or couple psychotherapy sessions while the patient is present.
- 90853: CPT Code 90853 refers to group therapy sessions. These groups aren’t specifically families.
Crisis Psychotherapy Codes
- 90839: CPT Code 90839 refers to Crisis Intervention Sessions. These sessions can be as long as 15 to 60 minutes. The duration can be up to 74 minutes in some cases.
- +90840: The CPT Codes 90839 and 90840 refer to the same service but different durations. The 90840 unit is triggered if the client needs a minimum of 15 additional minutes.
Behavioral Health Integration (BHI) vs. Collaborative Care Management (CoCM)
Behavioral Health Integration (BHI) and Collaborative Care Management (CoCM) are both tailored to deliver behavioral health services using a distinctive approach. Both services flow with clinical roles, and billing pathways. BHI (CPT 99484) focuses on general behavioral health care management. It requires at least 20 minutes per month of behaviorally focused care. It is often led by a designated care manager who collaborates with the primary care provider. Their responsibility is to create, review, and revise a patient-centered behavioral health care plan.
On the other hand, CoCM is an intensive psychiatrist-led model with determined time periods. The first month is considered under 99492 (70 minutes), followed by ongoing monthly management billed under 99493 (60 minutes).
When additional clinical time is needed, 99494 bills extra 30-minute increments, while G2214 captures shorter, non-standard time intervals.
Now, BHI delivers general behavioral health oversight, while CoCM includes structured psychiatric consultation and a more rigorous care-management framework. Both models require thorough documentation, including patient assessments, care-plan updates, and confirmation of required time thresholds.
Telehealth Changes and Updates for 2026
Telehealth Changes for 2026 are scheduled for the annual updates starting from January 2026. Behavioral health telehealth services remain free from geographic and originating site restrictions, allowing beneficiaries to receive services from home in both rural and urban areas.
The updated document includes following changes:
In-Person Visit Requirements
After January 30, 2026, an in-person visit is required within 6 months before the first mental health telehealth service. Later on, a visit is required every 12 months.
Audio-Only Telehealth Rules
Audio-only telehealth remains allowed for behavioral health services. However, it is important to understand that the practitioner can offer video, but the patient cannot or does not consent to using it.
Practitioner Eligibility Changes
A lot of practitioners may now bill telehealth after January 30, 2026. After January 31, 2026, Physical Therapists, Occupational Therapists, Speech-Language Pathologists , and audiologists are removed from Medicare telehealth eligibility.
Putting It All Together
The healthcare authorities strengthen their approach towards expanding mental health services, especially in the senior citizen sector of the US. As the exposure grows, the requirement for accurate CPT coding in practice becomes more crucial.
The authorities place their focus on providing resources to their patients to assist them in their journey towards wellness. They work towards providing a comfortable place to engage with the patients and the equipment to help them overcome their mental health difficulties.
The mental health experts at Rhode Island Medical Billing prioritize resolving your issues. They focus on speaking the right language through precise CPT Codes, allowing the healthcare providers, billing authorities, and patients to follow through with an appropriate financial viability, ensuring correct insurance reimbursement, preventing claim denials, and boosting practice revenue.
Reach out to us for dependable medical coding support and streamline your claim submissions to maximize your practice’s revenue.
FAQs
Q1: What are the changes in CPT Codes for 2026?
A1: The AMA has recently updated the CPT Codes for 2026 featuring new codes for digital health/ AI, hearing devices, and cardiovascular procedures.
Q2: What is the CPT Code for Phycological Billing?
A2. NCCI – 2025 The psychiatric diagnostic interview examination (CPT codes 90791, 90792), psychological/ neuropsychological testing (CPT codes 96136-96146), and psychological/ neuropsychological evaluation services (CPT codes 96130-96133) must be distinct services if reported on the same date of service.
Q3. What is the CPT Code for Prolonged Services?
+99417 for outpatient/office/home/cognitive services (after the primary E/M time, in 15-min increments) and +99418 for inpatient/nursing facility care (also in 15-min increments)
Q4. What is CPT Code 99600 used for?
A4 . CPT code 99600 describes an “Unlisted home visit service or procedure