Mental Health CPT Codes & Guidelines 2024

Psychology, psychiatry, therapy, counseling, or whatever your area of expertise may be, convincing insurance companies to pay for your services on the first pass is a challenge. But we don’t blame you since mental health billing requires more attention than other specialties.

The billing process for mental health is different from the standard method due to the wide variety of services, session length, therapies’ approach, and behavior of the patients.

The complexity is further increased with changing coding guidelines. We may not be able to train your in-house staff, but we can certainly offer information on the latest CPT codes for mental health services. Let’s explore some of the most common ones.

Common CPT Codes for Mental Health Services

Annual coding revisions are troublesome for healthcare professionals. However, they are crucial for improving patient care because they reflect the latest best practices and innovations in treatment methods. Therefore, you should have a dedicated coding expert to monitor these yearly updates.

The Current Procedural Codes (CPT), maintained by the American Medical Association (AMA), include a wide range of screening, treatment, and preventive mental health CPT codes. However, you’ll be surprised to know that only a few are used more frequently. Let’s explore these commonly used CPT codes for mental health services.

Mental Health CPT Codes for Diagnostic Procedures

CPT Code 90791 – Psychiatric Diagnostic Evaluation

The 90791 medical procedure code focuses on the psychiatric evaluation of a patient. Psychiatrists use this code to bill the first clinical assessment they perform to identify their new patient’s mental disorder. 

In this session, they only ask a series of questions to understand their patient’s symptoms and do not offer any additional medical service.

Mental Health CPT Codes for Psychotherapy Services

CPT Code 90832 – 30 min. Session of Psychotherapy

The 90832 mental health CPT code is one of the time-based psychotherapy codes. This code addresses a short psychotherapy session lasting approximately 30 minutes (16 to 37 minutes, to be more specific). Psychologists use CPT code 90832 to file a claim for individual talk therapy.

CPT Code 90837 – 53 to 60 min. Session of Psychotherapy

This mental health CPT code addresses one of the psychotherapy services. Psychologists use CPT code 90837 to bill a 60-minute one-on-one treatment session with their patients. They perform this talk therapy to treat their patient’s mental health issues, including distressing emotions and psychological disorders.

CPT Code 90838 – 60 mins. Psychotherapy with E/M Service

The 90838 CPT code also addresses an individual 60-minute psychotherapy session, but along with an additional service. Psychologists use this mental health CPT code after performing psychotherapy with an evaluation and management (E/M) service.

In this psychotherapy procedure, in addition to treating mental disorders, psychologists conduct a series of assessments to evaluate the current progress. It allows them to upgrade their patient’s treatment plans.

Mental Health CPT Codes for Crisis Psychotherapy Services

CPT Code 90839 – Emergency Therapy

It is one of the crisis psychotherapy CPT codes. Professionals use the mental health CPT code 90839 to specify an emergency therapy session. These crisis psychotherapy sessions are performed when a psychotherapist feels that a patient is in critical condition and may harm himself. 

The 90839 CPT code is used to bill these high-risk counseling sessions, which can last up to 74 minutes.

Mental Health CPT Codes for Family Psychotherapy Services

CPT Code 90846 – Family Counseling w/o Patient

The 90846 CPT code addresses family psychotherapy. Mental health professionals use this code when they provide counseling to a patient’s family on his/her mental illness. In this session, the patient is usually absent.

CPT Code 90847 – Family Counseling with Patient

CPT code 90847 is quite similar to CPT code 90846. However, psychologists use this code to bill a family psychotherapy service where the patient is also present. This service becomes essential when one-on-one sessions become insufficient to treat the client’s mental illness. 

In short, the 90847 CPT code indicates a group therapy conducted to explore the family’s role in the patient’s treatment.  

Mental Health CPT Codes for Group Psychotherapy Services

CPT Code 90853 – Group Therapy for People with Similar Issues

The 90853 CPT code indicates that a mental health professional has performed group psychotherapy. Psychotherapists use this code when they provide therapy sessions to a bunch of people with similar mental disorders. 

These types of groups usually include up to 12 patients who are usually not acquainted with each other. In simple words, professionals use CPT code 90853 to claim reimbursement for a 45 to 60-minute group therapy session.

Mental Health CPT Codes for Other Psychiatric Services

CPT Code 90875 – Psychophysiological Therapy

The 90875 CPT code specifies a popular psychiatric procedure. Licensed mental health professionals, like psychologists, use this code to bill psychophysiological services – treatments combining physical activities with psychological therapies.

In this procedure, therapists try to alter the patient’s behavior via psychotherapy and biofeedback training. This involves talking with the patient for 30 minutes and using sensors to monitor their physical responses, including heart rate and muscle tension.

Mental Health CPT Codes for Preventive Medicine

CPT Code 99404 – Individual Counseling for Reducing Risks

The 99404 CPT code addresses an unrelated appointment to a routine preventive medicine checkup. Healthcare providers use this code to request payment for a 60-minute counseling session on important mental health topics. Providers use their patients’ age, family background, and underlying problems to offer advice.

Mental Health Coding Guidelines

Unlike other specialties, the billing process for mental health heavily depends on the therapy’s approach and length of sessions. Hence, each practice follows a non-standard method, based on their unique challenges, to claim reimbursements for their services. Consequently, coding for mental health is more complicated than others.

Mental health is an umbrella term for a wide range of emotional, psychological, and social aspects of well-being. As a result, mental healthcare also includes a wide range of services. Psychotherapy, counseling, diagnostic assessments, preventive medicine, crisis prevention sessions, and more, each category is further divided based on different conditions and therapy sessions and requires specific coding.

If you are not familiar with these CPT codes for mental health and their revisions, insurance companies will deny your medical claims. You can follow our mental health coding guidelines to save yourself from additional stress.

Familiarize Yourself with Common Mental Health CPT Codes

Let’s be real! Nobody has the time to learn every mental health CPT code. The more practical solution is to familiarize yourself with the most used codes for different types of mental health services, including evaluation and assessment, psychotherapy, and prevention.

Maintain Proper Documentation

If you run a busy practice, chances are that you might not remember every single detail. Therefore, document all the important information, including the type of service and duration. Since many mental health CPT codes are based on the length of a session, proper documentation can save you from selecting the wrong code.

Keep Up with Annual Coding Revisions

Most importantly, use the latest CPT codes when filing medical claims for your services. As mentioned previously, the American Medical Association updates CPT codes every year to include the latest practices and new treatments.

We know that it is not easy to keep up with these changes, especially with busy schedules. Therefore, hire a coding specialist who can easily follow these revised guidelines.

Use Modifiers

Don’t forget to include modifiers in your claim when applicable. These modifiers offer additional information to the payers about the provided services and increase the chances of claim approvals. The following are some of the most common modifiers used in mental health billing.

• Modifier 25: You can use it to indicate that you have provided an E/M service on the same day as another mental health service.
• Modifier 59: You can use it to clarify that the provided service was separate from other treatments offered on the same day.
• Modifier HE: You can use it to address a mental health program.

Hire A Professional Coding Expert

While a career in mental health brings diverse opportunities, it is also quite emotionally taxing. Working with different people with severe mental health conditions can quickly take a toll on anyone’s health. Therefore, it is understandable that most professionals don’t have the time to keep up with mental health CPT codes and their annual revisions.

So, what’s the ideal solution in this case? The answer is right in front of you! Outsource mental health billing services to an expert. Go through the top medical coding companies and hire reliable AAPC-certified coders to simplify your job.

Bottom Line

Don’t give the insurance companies a chance to deny your claims! Whether you run a small and independent counseling practice or a large rehabilitation center, familiarize yourself with the latest CPT codes for mental health services to avoid common mistakes. 

If you are managing everything in-house, hire a proper coding team to code every procedure accurately. Otherwise, invest in a reliable medical coding service provider to receive timely payments.