Psychotherapy CPT Code Chart 2026: Every Code, Time Range, and Rate
Psychotherapy CPT codes define the billing structure for every type of therapy session — individual, family, group, crisis, and diagnostic evaluation — with reimbursement determined by session duration, provider type, and whether medical services are included. In 2026, the core psychotherapy codes are 90832 (16–37 minutes, ~$82), 90834 (38–52 minutes, ~$116), and 90837 (53+ minutes, ~$154) for individual therapy, with corresponding add-on codes 90833, 90836, and 90838 when psychotherapy is delivered alongside an E/M service.
This chart covers every psychotherapy CPT code in use today: individual therapy, E/M add-on psychotherapy, diagnostic evaluations, crisis intervention, family therapy, group therapy, and add-on codes for interactive complexity and pharmacologic management. Each code includes the time range, approximate 2024 National Medicare reimbursement rate, who can bill it, documentation requirements, and telehealth eligibility. Bookmark this page as your quick reference for psychotherapy billing.
Individual Psychotherapy Codes
Individual psychotherapy codes are the most commonly billed codes in mental health practice. Time refers to face-to-face psychotherapy time with the patient, not total appointment length or documentation time.
| CPT Code | Description | Time Range | Medicare Rate* |
|---|---|---|---|
| 90832 | Individual psychotherapy, 30 minutes | 16–37 minutes | ~$82 |
| 90834 | Individual psychotherapy, 45 minutes | 38–52 minutes | ~$116 |
| 90837 | Individual psychotherapy, 60 minutes | 53+ minutes | ~$154 |
*Approximate 2024 National Medicare Physician Fee Schedule non-facility rates. Actual rates vary by locality, payer, and contract.
Key rule: The time boundaries are strict. A session with 37 minutes of face-to-face psychotherapy is 90832. A session with 38 minutes is 90834. A session with 52 minutes is 90834. A session with 53 minutes is 90837. Billing 90837 for a session under 53 minutes is the single most common psychotherapy audit finding.
Time Documentation Best Practice
Document start and stop times for the psychotherapy portion of every encounter: “Psychotherapy provided 2:10 PM to 2:55 PM (45 minutes face-to-face).” Auditors compare documented times against scheduling data. Sessions consistently documented as exactly the slot length (e.g., every session is exactly 45 minutes) are flagged as suspicious.
E/M + Psychotherapy Add-On Codes
When a prescribing provider (psychiatrist, PMHNP, PA, or physician) performs both an E/M service and psychotherapy in the same encounter, the psychotherapy portion is billed as an add-on code appended to the primary E/M code. For example, a psychiatrist who spends 15 minutes on medication management (E/M) and 40 minutes on CBT (psychotherapy) bills 99214 + 90836.
| Add-On Code | Description | Psychotherapy Time | Billed With | Medicare Rate* |
|---|---|---|---|---|
| 90833 | Psychotherapy add-on, 30 min | 16–37 minutes | E/M code (e.g., 99213) | ~$68 |
| 90836 | Psychotherapy add-on, 45 min | 38–52 minutes | E/M code (e.g., 99214) | ~$96 |
| 90838 | Psychotherapy add-on, 60 min | 53+ minutes | E/M code (e.g., 99215) | ~$126 |
*Approximate 2024 National Medicare Physician Fee Schedule non-facility rates for the add-on code only. The E/M code reimburses separately at its own rate.
Who can bill add-on codes: Only providers who can independently bill E/M codes — physicians (MD/DO), PMHNPs, PAs, and in some states NPs with independent practice authority.LCSWs, LPCs, and psychologists (PsyD/PhD) without prescriptive authority cannot bill E/M codes and therefore cannot use add-on psychotherapy codes. They bill standalone individual therapy codes (90832, 90834, 90837) instead.
Revenue Impact: E/M + Add-On vs. Standalone
A psychiatrist billing 99214 + 90836 (E/M + 45-min psychotherapy add-on) receives approximately $167 + $96 = $263 for the encounter. Billing only 90834 (standalone 45-min therapy) for the same visit yields $116 — a difference of $147 per visit. Prescribers who provide both medical evaluation and psychotherapy should always bill E/M + add-on rather than standalone therapy codes.
Diagnostic Evaluation Codes
Diagnostic evaluations are used for the initial comprehensive psychiatric assessment. The choice between 90791 and 90792 depends on whether a medical evaluation is performed.
| CPT Code | Description | Medical Services | Who Can Bill | Medicare Rate* |
|---|---|---|---|---|
| 90791 | Psychiatric diagnostic evaluation without medical services | No | LCSW, LPC, PsyD, PhD, MD, DO, PMHNP, PA, NP | ~$195 |
| 90792 | Psychiatric diagnostic evaluation with medical services | Yes — includes physical exam, lab review, or medication evaluation | MD, DO, PMHNP, PA, NP | ~$222 |
*Approximate 2024 National Medicare Physician Fee Schedule non-facility rates.
Documentation requirements: Both codes require a comprehensive psychiatric history, mental status examination (MSE), risk assessment, and diagnostic formulation. 90792 additionally requires documentation of a medical evaluation: physical examination findings, review of lab results, medication history and assessment, or other medical services. Billing 90792 without documenting the medical component is a compliance risk.
Crisis Psychotherapy Codes
Crisis psychotherapy codes are used for urgent, unscheduled psychotherapy sessions provided to a patient in crisis. These are not for routine sessions with distressed patients — the patient must be in an acute mental health crisis requiring immediate intervention.
| CPT Code | Description | Time | Medicare Rate* |
|---|---|---|---|
| 90839 | Psychotherapy for crisis, first 60 minutes | First 60 minutes | ~$183 |
| 90840 | Psychotherapy for crisis, each additional 30 minutes (add-on) | Each additional 30 min | ~$91 |
*Approximate 2024 National Medicare Physician Fee Schedule non-facility rates.
Documentation must establish crisis criteria: the note must describe the nature of the crisis (suicidal ideation with plan, psychotic break, acute danger to self or others, severe dissociation, etc.), why the session was urgent/unscheduled, the interventions provided (safety planning, de-escalation, crisis stabilization), and the disposition (e.g., voluntary admission, safety plan with follow-up, crisis resolved). Routine therapy sessions billed as crisis codes are a major audit red flag. 90840 can be billed multiple times for extended crisis sessions (e.g., a 2.5-hour crisis session = 90839 + 90840 x3).
Family Therapy Codes
| CPT Code | Description | Patient Present? | Time | Medicare Rate* |
|---|---|---|---|---|
| 90846 | Family psychotherapy without patient present | No | 50 minutes | ~$119 |
| 90847 | Family psychotherapy with patient present | Yes | 50 minutes | ~$120 |
*Approximate 2024 National Medicare Physician Fee Schedule non-facility rates.
For 90846, the therapist meets with family members to address the identified patient’s treatment — the patient is not in the session. Common scenarios: parent coaching for a child’s treatment, psychoeducation with a spouse about a partner’s diagnosis, or family session when the patient is medically unable to attend. The note must still identify the patient whose treatment is being addressed.
For 90847, both the patient and family members participate together. Neither family therapy code should be billed on the same day as individual psychotherapy (90832–90837) unless the sessions are clearly distinct in time, purpose, and documentation.
Group Therapy
| CPT Code | Description | Group Size | Medicare Rate* |
|---|---|---|---|
| 90853 | Group psychotherapy (other than of a multiple-family group) | Typically 6–12 patients | ~$36/patient |
*Approximate 2024 National Medicare Physician Fee Schedule non-facility rate per patient.
90853 is billed per patient in the group. A group of 8 patients generates 8 separate claims, each for approximately $36 — totaling roughly $288 for a single group session. Documentation must be individualized for each patient: a note describing the group topic, each patient’s participation, clinical observations, and treatment progress specific to that individual. Identical notes for all group members are an audit finding. Group sessions via telehealth require all participants to have audio/video capability and the provider must be able to observe all participants.
Add-On Codes: Interactive Complexity and Pharmacologic Management
| CPT Code | Description | When to Use | Medicare Rate* |
|---|---|---|---|
| 90785 | Interactive complexity (add-on) | Communication barriers, interpreter use, maladaptive third-party behavior, caregiver management | ~$16 |
| 90863 | Pharmacologic management (add-on, not separately billable by Medicare) | Medication management during psychotherapy by non-physician (limited use) | ~$35 |
*Approximate 2024 National Medicare Physician Fee Schedule non-facility rates.
90785 (Interactive Complexity) is added to any primary psychotherapy or diagnostic code when at least one of four qualifying factors is present and documented: (1) managing maladaptive communication among participants; (2) caregiver emotions/behavior requiring management; (3) interpreter/translator use or communication barriers; (4) need to coordinate with third parties during the session (CPS, probation, school staff). It is frequently under-billed in child/adolescent practices, multilingual practices, and forensic settings.
90863 (Pharmacologic Management) is a limited-use add-on for medication management provided during a psychotherapy session by a non-physician provider.Medicare does not reimburse 90863 separately — it is bundled into the psychotherapy payment. Some commercial payers do reimburse it. Physicians and PMHNPs who manage medications should bill E/M + psychotherapy add-on codes instead, which reimburse significantly more.
Provider Type Billing Guide
Not every provider can bill every psychotherapy code. The table below shows which codes each provider type can use under standard Medicare and most commercial payer rules.
| CPT Code | LCSW / LPC | PsyD / PhD | MD / DO | PMHNP | NP / PA |
|---|---|---|---|---|---|
| 90832, 90834, 90837 | Yes | Yes | Yes | Yes | Yes |
| 90833, 90836, 90838 | No | No* | Yes | Yes | Yes |
| 90791 | Yes | Yes | Yes | Yes | Yes |
| 90792 | No | No | Yes | Yes | Yes |
| 90839, 90840 | Yes | Yes | Yes | Yes | Yes |
| 90846, 90847 | Yes | Yes | Yes | Yes | Yes |
| 90853 | Yes | Yes | Yes | Yes | Yes |
| 90785 | Yes | Yes | Yes | Yes | Yes |
*PsyD/PhD with prescriptive authority (in states that allow it, e.g., Louisiana, New Mexico, Illinois, Iowa, Idaho) can bill E/M + add-on codes.
Documentation Requirements by Code Category
Individual Psychotherapy (90832, 90834, 90837)
- Psychotherapy start and stop times (face-to-face, not total appointment)
- Chief complaint or session focus
- Therapeutic modality used (CBT, DBT, psychodynamic, EMDR, etc.)
- Mental status examination (at minimum: appearance, mood, affect, thought process, cognition, insight/judgment)
- Interventions delivered and patient response
- Risk assessment (suicidal ideation, homicidal ideation, safety concerns) when clinically indicated
- Treatment plan updates, homework, and follow-up plan
E/M + Add-On (99213/99214/99215 + 90833/90836/90838)
- All individual psychotherapy documentation requirements above
- Separate documentation of the E/M component: medication review, side effects, vitals (if taken), physical exam findings, medical decision making
- Clear delineation of E/M time vs. psychotherapy time
- E/M code level supported by MDM complexity or total time
Diagnostic Evaluations (90791, 90792)
- Comprehensive psychiatric history (presenting complaint, HPI, psychiatric history, substance use, family psychiatric history, social history, developmental history)
- Complete mental status examination
- Risk assessment
- Diagnostic formulation with DSM-5-TR diagnoses
- Treatment recommendations and plan
- For 90792 only: physical examination findings, laboratory review, medication evaluation
Crisis Codes (90839, 90840)
- Nature and severity of the crisis (what makes this a crisis vs. a difficult session)
- Assessment of danger to self/others, psychosis, or acute functional deterioration
- Crisis interventions provided (safety planning, de-escalation, containment, coordination with emergency services)
- Disposition and safety plan
- Start and stop times documenting the full crisis intervention duration
- Reason the session was urgent or unscheduled
Common Psychotherapy Billing Mistakes
| Mistake | Impact | Prevention |
|---|---|---|
| Wrong time bracket | Billing 90837 for <53 min sessions (overpayment, audit recoupment) | Document exact start/stop times; use time-based code selector |
| Missing MSE | Note lacks mental status examination (audit finding, documentation deficiency) | Template with mandatory MSE section; even brief MSE qualifies |
| Cloned notes | Identical notes across sessions (fraud indicator, recoupment risk) | Individualize every note; document specific session content and patient response |
| Add-on without E/M | Submitting 90833/90836/90838 without primary E/M code (auto-denial) | Claim scrubber should reject add-on codes without primary E/M on same claim |
| LCSW billing 90792 | Non-prescriber using medical evaluation code (compliance violation) | Restrict 90792 to MD, DO, PMHNP, PA, NP in EHR code picklist |
| Crisis codes for routine sessions | Using 90839 for non-crisis sessions (significant audit risk, potential fraud) | Reserve 90839/90840 for documented acute crises; require crisis criteria in note |
| Under-billing interactive complexity | Missing legitimate 90785 add-ons (lost revenue, ~$16/session) | Screen every session for interpreter use, caregiver management, third-party coordination |
Telehealth Applicability
All primary psychotherapy CPT codes are eligible for telehealth delivery under Medicare and most commercial payers in 2026.
| CPT Code(s) | Audio/Video (Mod 95) | Audio-Only (Mod 93) | Notes |
|---|---|---|---|
| 90832, 90834, 90837 | Yes | Yes | BH exception allows audio-only for established patients |
| 90833, 90836, 90838 | Yes | Yes | Add modifier to E/M code, not the add-on |
| 90791, 90792 | Yes | Limited | New patient audio-only permitted for BH under Medicare |
| 90839, 90840 | Yes | Yes | Crisis intervention telehealth-eligible |
| 90846, 90847 | Yes | Limited | High telehealth adoption; verify all participants have audio/video |
| 90853 | Yes | No | Provider must observe all participants; audio-only not practical |
| 90785 | Yes | Yes | Interpreter-mediated telehealth is a common trigger |
For all telehealth psychotherapy sessions: use modifier 95 for audio/video, modifier 93 for audio-only (with documented reason), POS 10 if patient is at home, POS 02 if patient is at a facility. Document the telehealth modality, platform, patient location, and consent.
Frequently Asked Questions
What is the difference between 90834 and 90837?
CPT 90834 and 90837 are both individual psychotherapy codes, but they differ in session duration and reimbursement. 90834 covers sessions lasting 38 to 52 minutes and reimburses approximately $116 under Medicare. 90837 covers sessions lasting 53 minutes or longer and reimburses approximately $154. The time refers to face-to-face psychotherapy time with the patient, not the total appointment slot. If a session intended to be 45 minutes runs to 54 minutes of face-to-face therapy, 90837 is the correct code. If it ends at 51 minutes, 90834 is correct. Billing 90837 for sessions under 53 minutes is one of the most common psychotherapy billing errors and a frequent audit target. Always document start and stop times for the psychotherapy portion of the encounter.
When should I use psychotherapy add-on codes (90833, 90836, 90838) instead of standalone therapy codes?
Psychotherapy add-on codes (90833, 90836, 90838) are used when a physician, PMHNP, or other qualified prescriber performs BOTH an E/M service (medical evaluation and management) AND psychotherapy during the same encounter. The add-on code is appended to the primary E/M code (e.g., 99214 + 90836). This is common in psychiatric practice where the provider evaluates medication efficacy, adjusts prescriptions, AND delivers psychotherapy in the same visit. Non-prescribing therapists (LCSW, LPC, PsyD without prescriptive authority) cannot bill E/M codes and therefore cannot use add-on psychotherapy codes. They bill standalone therapy codes (90832, 90834, 90837) instead. The add-on codes use the same time thresholds as standalone codes: 90833 (16-37 min), 90836 (38-52 min), 90838 (53+ min).
Can an LCSW bill for 90791 diagnostic evaluation?
Yes. CPT 90791 (psychiatric diagnostic evaluation without medical services) can be billed by LCSWs, LPCs, psychologists (PsyD/PhD), and other licensed mental health professionals. It covers the initial comprehensive assessment including history, mental status examination, and diagnostic formulation without any medical evaluation component. CPT 90792 (psychiatric diagnostic evaluation WITH medical services), however, requires a medical evaluation and can only be billed by physicians (MD/DO), PMHNPs, PAs, and other providers who perform a physical examination and can order diagnostic tests as part of the evaluation. The distinction is the medical component: 90791 is for diagnostic interview and assessment only; 90792 adds the medical examination. LCSWs should always use 90791, never 90792.
How do I document time for psychotherapy coding?
Psychotherapy time documentation must capture the face-to-face psychotherapy time with the patient, not the total appointment duration. Best practice is to document both start and stop times for the psychotherapy portion: "Psychotherapy provided from 2:10 PM to 2:55 PM (45 minutes face-to-face)." For add-on codes used with E/M services, document the psychotherapy time separately from the E/M time: "E/M service: 15 minutes reviewing labs, medication adjustment, and physical assessment. Psychotherapy: 40 minutes of CBT for generalized anxiety." The total encounter might be 55 minutes, but the psychotherapy-specific time of 40 minutes determines the add-on code (90836 for 38-52 minutes). Round to the nearest minute. Do not estimate or use the appointment slot length. Auditors compare documented times against scheduling data, and consistent exact-slot-length documentation (e.g., every session documented as exactly 45 minutes) is an audit red flag.
What is interactive complexity (90785) and when should I bill it?
CPT 90785 is an add-on code for interactive complexity, billed in addition to a primary psychotherapy code (90832, 90834, 90837, 90791, or 90792) when specific communication factors significantly complicate the delivery of the service. The four qualifying factors are: (1) the need to manage maladaptive communication among participants that complicates delivery (e.g., a parent who undermines treatment during a child session); (2) caregiver emotions or behavior that requires management during the session; (3) use of interpreter or translator services, or communication with a patient who has a communication barrier (hearing impaired, non-verbal, etc.); (4) the need to integrate services with third parties involved in the patient's care (e.g., coordinating with child protective services, probation officer, or school during the session). At least one factor must be present AND documented. The add-on reimburses approximately $16 under Medicare. It cannot be billed alone and is frequently under-billed in practices that treat children, use interpreters, or coordinate with external agencies.
Can psychotherapy codes be billed via telehealth?
Yes. All primary psychotherapy CPT codes (90832, 90834, 90837, 90791, 90792, 90846, 90847, 90853) are eligible for telehealth delivery under Medicare and most commercial payers as of 2026. Append modifier 95 for synchronous audio/video telehealth or modifier 93 for audio-only telehealth (with documented reason why video was not used). Use Place of Service 10 when the patient is at home or POS 02 when the patient is at a facility. Crisis codes (90839, 90840) are also telehealth-eligible. Group therapy (90853) via telehealth requires that all participants have audio/video capability and the provider can observe all participants. Family therapy codes (90846, 90847) work well via telehealth and have seen significant telehealth adoption. Documentation requirements are the same as in-person plus the telehealth-specific additions: modality, platform, patient location, and consent.
What is the difference between 90846 and 90847 family therapy?
CPT 90846 is family psychotherapy WITHOUT the patient present, and CPT 90847 is family psychotherapy WITH the patient present. Despite the seemingly significant difference, their Medicare reimbursement is nearly identical: approximately $119 for 90846 and $120 for 90847. The clinical distinction matters for documentation and treatment planning. 90846 is used when the therapist meets with family members to address the patient's treatment without the patient in the room. Common scenarios include meeting with parents about a child's treatment plan, coaching a spouse on supporting a partner with substance use disorder, or family psychoeducation about a patient's diagnosis. 90847 is used when both the patient and one or more family members participate in the therapy session together. The note for 90846 must still identify the patient whose treatment is being addressed (the family members are not the patient). Both codes require 50 minutes of face-to-face time. Neither code should be billed on the same day as individual psychotherapy (90832-90837) unless the sessions are clearly distinct in time, purpose, and documentation.
What are the most common psychotherapy billing mistakes that trigger audits?
The five most common psychotherapy billing mistakes are: (1) Wrong time bracket: billing 90837 (53+ minutes) for sessions that were actually 38-52 minutes, which should be 90834. This is the number one audit finding in psychotherapy practices. (2) Missing mental status examination (MSE): every psychotherapy note must include at minimum a brief MSE documenting the patient's presentation. "Alert, oriented, cooperative, with congruent affect" is sufficient; a completely absent MSE is not. (3) Cloned notes: copy-pasting the same note across multiple sessions with only the date changed. Auditors flag identical or near-identical documentation across encounters as evidence of insufficient individualized assessment. (4) Billing add-on codes without E/M: submitting 90833, 90836, or 90838 without an accompanying E/M code on the same claim. Add-on codes cannot stand alone. (5) Billing 90792 without medical services: using the diagnostic evaluation code that includes medical services without documenting a physical examination or medical evaluation component. LCSWs and psychologists should use 90791, not 90792.
Get Psychotherapy Codes Right Every Time
Psychotherapy billing comes down to three decisions: which code category (individual, add-on, diagnostic, crisis, family, or group), the correct time bracket, and whether your provider type is authorized to bill that code. Get those three right, document time and MSE consistently, and your claims will be clean.
Continue building your psychotherapy coding knowledge: read the complete psychotherapy CPT codes billing guide, explore E/M coding for mental health beyond psychotherapy, or see how the CodeItRight.ai analyzer handles psychotherapy notes for therapists, psychiatrists, and PMHNPs.