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Seeking clarity on current procedural terminology (CPT) codes for mental health?
You’ve come to the right place.
This guide provides essential facts and a comprehensive list of the most commonly used mental health CPT codes.
Data driven insights on the top mental health CPT codes
To gain insight into U.S. behavioral health trends, SimplePractice analyzed utilization data from more than 225,000 U.S.-based practitioners who use SimplePractice’s HIPAA-compliant therapist electronic health record (EHR) system.
This analysis identified the 10 most frequently used CPT codes by mental health clinicians when billing health insurance.
This data reveals the most common mental health treatments and services provided to clients across the United States over the previous year, offering valuable insights for practitioners managing their billing practices.
What is a current procedural terminology code (aka CPT code)?
Current procedural terminology codes (aka CPT codes) are developed by the American Medical Association (AMA). They are a standardized coding system for describing medical services and treatments.
Put simply, these codes refer to the actions a health care provider took during an interaction with or on behalf of their client or patient.
Similarly to ICD codes, CPT codes are updated annually, and are used by both federal healthcare programs like Medicaid and Medicare, as well as private insurers, to describe services, to track healthcare utilization, and to identify services to determine payment amounts.
Using the proper codes is vital to getting paid in full and avoiding insurance audits—specifically for the therapists who are on insurance payer panels or who provide superbills to clients.
Different CPT code categories—understanding the differences
CPT codes are organized into three distinct categories:
Category I: Most healthcare providers use these five-digit codes, which identify specific, well-established procedures. U.S. insurers generally must reimburse for Category I procedures when they are performed by qualified health professionals and medically necessary for treating a client’s condition.
Category II: These optional codes gather information about quality of care and performance measurement and are not required for billing purposes.
Category III: These temporary codes are designated for emerging technologies, services, and procedures. They were created for data collection and assessment, and in some cases, for payment of new services that don’t meet the criteria for Category I codes.
Top-billed mental health CPT codes
Our analysis reveals the most frequently billed CPT codes used by behavioral health clinicians across the U.S.
This data offers valuable insight into common mental health treatment modalities and services.
Unsurprisingly, the most-billed CPT code nationwide was for 60-minute psychotherapy sessions.
When examining the top mental health CPT codes, various forms of psychotherapy—both in-person and telehealth sessions of different durations—appeared multiple times in the top ten mental health services.
CPT codes psychotherapy time rules
The following three psychotherapy CPT codes are time-based:
- 90837: Psychotherapy, 60 mins with patient
- 90834: Psychotherapy, 45 mins with patient
- 90791: Psychiatric diagnostic evaluation
- 90847: Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes
- 90834-95: Psychotherapy 45 min, telehealth
- 90853: Group psychotherapy (other than of a multiple-family group)
- 90832: Psychotherapy, 30 minutes with patient
- 90837-95: Psychotherapy, 60 mins, telehealth modifier
- 97803: Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes
- 99214: Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making
- 90832: 30-minute psychotherapy
- 90834: 45-minute psychotherapy
- 90837: 60-minute psychotherapy
Additionally, the time for each of these codes is described as time spent with the client and/or their family. Although each code specifies a particular duration, the AMA provides flexibility in the actual session length:
- 90832: Billable for sessions with a total duration of 16-37 minutes
- 90834: Billable for sessions with a total duration of 38-52 minutes
- 90837: Billable for sessions lasting 53 minutes or longer
When billing time-based codes, always verify the exact duration range each code covers according to current guidelines.
Staying Current on CPT Code updates
New CPT codes are released annually to keep pace with developments in healthcare. It’s important to stay informed about these updates:
- The AMA website provides comprehensive information about the annual updating process and specific changes
- While many code updates may not directly apply to mental health providers, reviewing the changes ensures you’re using the most accurate codes for your services
- Using outdated or deleted codes may result in denied reimbursement claims
How CPT Code Updates Impact Your Practice
Since CPT codes are used across multiple healthcare specialties, many updates may not apply to your specific billing needs. However:
- Regular review of annual updates is essential
- Using deleted codes or outdated versions may lead to denied reimbursements
- Setting aside dedicated time to review coding changes can prevent billing complications
Insurance billing for private practice requires attention to detail.
To avoid reimbursement issues, establish a routine for reviewing coding updates and implement processes to ensure your practice stays current with the latest billing requirements.
How SimplePractice streamlines running your practice
SimplePractice is HIPAA-compliant practice management software with everything you need to run your practice built into the platform—from booking and scheduling to insurance and client billing.
If you’ve been considering switching to an EHR system, SimplePractice empowers you to run a fully paperless practice—so you get more time for the things that matter most to you.
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