Mental health billing and coding isn’t just about getting paid—it’s about translating the work you do every day into standardized language insurers understand. Unlike general medical billing, mental health services involve unique codes, session durations, therapy types, and even time-based reporting.
Whether you’re a solo psychiatrist or managing a multi-provider behavioral health clinic, understanding how to bill accurately can make or break your revenue cycle.
Let’s dive deep and make mental health billing feel less like decoding hieroglyphs and more like second nature.
Who This Guide is for:
- Psychiatrists & Neurologists
- Clinical Psychologists (PhD/PsyD)
- Licensed Clinical Social Workers (LCSWs)
- Marriage and Family Therapists (MFTs)
- Mental Health Counselors
- Group Practices and Behavioral Health Clinics
Key Components of Mental Health Billing
The key components of mental billing and coding include:
- CPT Codes for Mental Health Services
- ICD-10 Codes for Common Diagnoses
- Time-Based Billing Rules
- Telehealth Billing
- Credentialing & Insurance Paneling
- Documentation Best Practices
- Denials, Appeals, and Compliance
- Billing Software & Outsourcing Options
CPT Codes for Mental Health
Let’s break down Current Procedural Terminology (CPT) codes commonly used in mental health. These are the codes that tell the insurer what you did.
Evaluation & Management (E/M) Codes – Psychiatrist or MD/DO Only
For example:
- 99202–99205: New patient office visits
- 99212–99215: Established patient visits
If you’re a psychiatrist managing medications, you’re often using these alongside psychotherapy codes.
A 30-minute follow-up with med management = 99213 + 90833 (30-min therapy add-on)
Psychotherapy Codes – Time-Based and Provider-Specific
The psychotherapy codes include:
| CPT Code | Description | Time Duration |
| 90832 | Individual therapy | 16–37 mins |
| 90834 | Individual therapy | 38–52 mins |
| 90837 | Individual therapy | 53+ mins |
| 90846 | Family therapy (without patient) | Unspecified |
| 90847 | Family therapy (with the patient) | Unspecified |
| 90853 | Group therapy | 1 unit |
Example: A 60-minute therapy session = 90837
Psychiatric Diagnostic Evaluation
- 90791: Psych eval without medical services (psychologist, LCSW)
- 90792: Psych eval with medical services (psychiatrists, NPs)
These are often used for intake sessions or when a patient is new to your clinic.
Add-on Codes for Medication Management
- +90833: Add-on for 30-minute therapy with E/M
- +90836: Add-on for 45-minute therapy
- +90838: Add-on for 60-minute therapy
These are used when therapy is combined with medical checks.
ICD-10 Codes for Mental Health Diagnoses
CPT tells payers what you did, and ICD-10 tells them why. Without the correct ICD-10 codes, you won’t receive payment.
Common ICD-10 Codes
| Diagnosis | ICD-10 Code |
| Major Depressive Disorder, single, moderate | F32.1 |
| Generalized Anxiety Disorder | F41.1 |
| PTSD | F43.10 |
| ADHD, Combined Type | F90.2 |
| Bipolar Disorder I, current episode manic | F31.1 |
| Autism Spectrum Disorder | F84.0 |
| Schizophrenia | F20.9 |
| Substance Use Disorder | F10.20 to F19.20 |
Time-Based Billing Rules
Time matters—a lot. The billing rules for time-based services:
Psychotherapy codes are strictly time-based
Document the exact start and stop times in your notes.
Psychotherapy Billing Chart
| Duration | Billable Code |
| 16–37 mins | 90832 |
| 38–52 mins | 90834 |
| 53+ mins | 90837 |
Scenario: You meet a patient from 3:02 PM to 3:56 PM = 54 mins → Bill 90837
Telehealth in Mental Health Billing
Telehealth isn’t just a pandemic trend—it’s now a permanent part of mental health care. In fact, over 38% of mental health visits are now delivered remotely, according to recent CMS data. Whether you’re a solo therapist or part of a behavioral health group, knowing how to bill telepsychiatry and teletherapy services correctly is key to getting paid.
Psychiatric Diagnostic Evaluations (Telehealth)
- 90791 – Psych eval (non-MD/DO)
- 90792 – Psych eval with medical services (for psychiatrists)
Psychotherapy (Teletherapy)
| CPT Code | Description | Time |
| 90832 | Individual therapy | 16–37 min |
| 90834 | Individual therapy | 38–52 min |
| 90837 | Individual therapy | 53+ min |
| 90846 | Family therapy (w/o patient) | 50 min |
| 90847 | Family therapy (with the patient) | 50 min |
| 90853 | Group therapy | 1 unit |
Psychotherapy + Med Management (Psychiatrists & NPs)
- 99212–99215 – E/M codes for med checks
- +90833 – 30-min therapy add-on
- +90836 – 45-min therapy add-on
- +90838 – 60-min therapy add-on
Example: A psychiatrist sees a patient for 45 minutes of therapy plus med management = 99213 + 90836
Modifiers for Telehealth
Modifiers are how you tell the payer, “This service was done via telehealth.”
Use:
- Modifier 95 – Synchronous telemedicine (real-time audio + video)
- Modifier GT – Some older systems/payers still require this, but it’s being phased out
- Modifier FQ – Audio-only telehealth (Medicare)
Example: 90834-95 (Psychotherapy, 45 min, audio/video telehealth)
Place of Service (POS) Codes for Telehealth
This indicates to the payer the location where the patient received care.
| POS Code | Description |
| 10 | Patient’s home (most common for mental health telehealth) |
| 02 | Anywhere else via telehealth (e.g., clinic, school, assisted living) |
Example: Psychotherapy via Zoom while the patient is at home → POS 10 + Modifier 95
Credentialing & Insurance Paneling
You can’t bill insurance until you’re credentialed.
What You Need:
- NPI Number (Type 1 for individuals, Type 2 for group practices)
- CAQH profile (updated and attested)
- State license & malpractice insurance
- Resume/CV & work history
- W-9 form
Credentialing takes 60–120 days on average per payer. Medicare and Medicaid are often slower.
Documentation for Mental Billing Services
Your notes should match your codes. It’s that simple—and that crucial.
A Few Must-Haves:
- Start and end time
- Type of therapy (CBT, DBT, etc.)
- Patient response
- Clinical observations
- Risk factors (especially with mood disorders or suicidal ideation)
Insurance audits are on the rise. Proper documentation can save you from clawbacks or fines.
Denials, Appeals & Common Mistakes
Denials occur due to incorrect codes or inaccurate documentation.
Common Billing Errors:
- Missing modifiers (like 95 for telehealth)
- Using the wrong POS codes
- Credentialing incomplete
- CPT doesn’t match documentation
- Lack of medical necessity
Appeal Process:
- Review EOB or denial letter
- Correct the issue
- Write a short appeal letter
- Attach supporting documents
- Refile within the payer’s appeal window (usually 30–90 days)
Billing Software & Outsourcing
Whether you’re billing in-house or outsourcing, using the right tools is key.
Popular Behavioral Health Billing Platforms:
- TheraNest
- SimplePractice
- Kareo
- AdvancedMD and more
If your practice is growing, consider outsourcing to a company that specializes in mental health billing, not just general medical billing.
According to APA, behavioral practices that outsource billing reduce denials by up to 30%.
Pro Tips for Mental Health Providers and Practices
Use Time Wisely—Bill the Right Code
Psychotherapy codes are strictly time-based. Track session duration precisely and never round up to the nearest minute. Insurers can audit your notes.
Always document exact start and end times in your clinical notes.
Verify Insurance Benefits Before First Visit
Many plans carve out behavioral health to separate payers like Optum or Magellan. Don’t assume mental health is included under standard medical benefits.
Always verify a patient’s coverage, copay, deductible, and mental health benefits before the first session.
Combine E/M and Therapy Codes for Higher Reimbursement
If you’re providing both medication management and therapy in the same session, bill an E/M code + add-on psychotherapy code.
Example: 99214 + 90836
Don’t leave money on the table by only billing one.
Document “Medical Necessity” Clearly
Most denials occur because documentation doesn’t justify the code.
Include language like:
“Patient exhibits symptoms of GAD (F41.1), including excessive worry, poor sleep, and restlessness. Treatment continues to be medically necessary to prevent clinical deterioration.”
Be Careful with Telehealth Coding
Use the correct modifier (95 or GT) and POS code (10 or 02), depending on the patient’s location and payer rules.
Medicare now requires POS 10 when services are provided at the patient’s home.
90791 and 90792 Can Only Be Billed Once Per Episode
These psychiatric evaluation codes are used once per provider per new treatment episode, not per visit.
If the patient returns after six months or more, document it as a new episode and justify the use of 90791/90792 again.
Stay on Top of Credentialing
Don’t let expired credentials or CAQH lapses delay your payments.
Create a calendar with renewal reminders for:
- NPI numbers
- CAQH attestations
- Licensure and malpractice
- Recredentialing every 2–3 years per payer
Avoid Common Billing Mistakes
Top reasons for denial:
- Using the wrong POS or modifiers
- Submitting 90837 for sessions under 53 mins
- Billing psychotherapy with no documented time
- Claiming telehealth without stating video/audio used
Audit 10 claims/month to catch recurring mistakes.
Track Your Denials and Appeals
Keep a spreadsheet or use your EHR to track denied claims, reasons, and outcomes.
Stats show that up to 35% of denied claims are never reworked. That’s lost revenue. Fight for your reimbursements.
Use Superbills for Out-of-Network Clients
If you’re not in-network, provide clients with clean, itemized superbills for insurance reimbursement.
Include:
- CPT and ICD-10 codes
- Provider NPI and Tax ID
- Service dates and times
Outsource Billing If You’re Drowning
If you’re seeing 15–20+ patients per week and billing yourself, you may be losing revenue.
Hiring a mental billing services provider that specializes in mental health can:
- Reduce denials
- Improve cash flow
- Free up your time to focus on patients
Stay Updated Every January
Billing codes and telehealth policies are subject to annual changes.
Sign up for updates from:
- CMS.gov
- AMA CPT Code updates
- Your EHR’s newsletter
- APA and NASW newsletters
Use Modifiers Correctly
Modifiers like 95, 25, and GT are not optional—they’re required for correct reimbursement.
Example: 99214 + 90836 + 25 modifier if both the med check and therapy are performed on the same day.
Batch Claims Every 2–3 Days
Waiting to submit claims weekly can delay your revenue cycle. Get paid faster by batching claims regularly.
Most electronic claims are paid within 10–14 days if submitted cleanly.
Know Your Numbers
Track key metrics:
- Days in AR (should be < 30)
- Clean claim rate (aim for 95%+)
- Denial rate (keep under 10%)
- Net collections (target 97%+)
Use dashboards in software like TheraNest, SimplePractice, or Kareo to visualize trends.
Conclusion
Mental health professionals do essential, life-saving work. But without proper billing and coding, even the most impactful therapy sessions can go unpaid. This guide serves as your foundation—combine it with strong administrative systems, clear documentation, and up-to-date training, and you’ll be well-equipped.
Take the Stress Out of Mental Health Billing
Let us handle the paperwork so you can focus on your patients.
Our specialized billing team understands the unique needs of psychiatrists, therapists, psychologists, and mental health clinics. We ensure accurate coding, fast claims processing, and fewer denials.
Schedule your free consultation today.