TheAmerican Medical Association’s 2026 CPT update introduced 288 new codes with significant implications for behavioral health practices. According to the AMA, these changes include expanded remote monitoring codes, digital mental health treatment recognition, and refined telehealth provisions affecting psychiatry, psychology, therapy, and counseling services.
What is the main challenge? Becker’s ASC Review reports that psychiatrists face a claim denial rate of 16%, which is significantly higher than the 5-10% industry average. This happens mainly due to coding errors, documentation gaps, and authorization issues. With denials reaching 11.8% in 2024 and rising, accurate CPT coding has become critical for practice sustainability. Mastering mental health CPT codes has become non-negotiable for maintaining healthy cash flow.
Common Mental Health CPT Codes for 2026
Most mental health providers work with about two dozen mental health CPT codes regularly. Since these codes are time-based, accurate session length documentation directly impacts reimbursement.
Diagnostic Evaluation
CPT Code 90791 – Psychiatric Diagnostic Evaluation
This code refers to the initial 60-minute psychiatric evaluation in which psychiatrists, psychologists, and clinical social workers collect complete medical and psychiatric histories, do mental status examinations, and provide an initial diagnosis. The examination focuses entirely on diagnostic assessment and excludes medical interventions. This code is used once per patient to establish the treatment plan basis.
Psychotherapy Services
CPT Code 90832 – Short-Session Psychotherapy
This CPT code for mental health refers to brief individual psychotherapy sessions lasting 16 to 37 minutes. These shorter sessions are suitable for focused interventions or brief check-ins. Providers must document the correct duration because crossing 38 minutes demands the next tier code, and under-coding means losing income.
CPT Code 90837 – Standard Psychotherapy Session
This value refers to extensive individual sessions lasting 53 minutes or more. When your session exceeds 53 minutes, you reach this higher reimbursement group. Payers will analyze these higher-paying codes more closely during audits, so precisely document the exact start and end periods.
CPT Code 90838 – Integrated Therapy and Medication Management
This code includes visits in which therapists provide both 60 minutes of psychotherapy and evaluation and management services in a single session. Psychiatrists commonly use this code when combining pharmaceutical control with extensive therapy intervention. To illustrate unique services, the documentation must clearly segregate the two components.
Crisis and Family Services
CPT Code 90839 – Crisis Psychotherapy
This CPT code for mental health applies to emergency therapy sessions lasting 30 to 74 minutes for patients in acute crisis posing immediate danger. Documentation must justify the crisis nature with a detailed description of acute presentation, imminent risk factors, and crisis-specific interventions provided. Reserve this for genuine psychiatric emergencies, not simply longer sessions.
CPT Code 90846 – Family Psychotherapy Without Patient
This code covers family counseling sessions lasting approximately 50 minutes without the patient present. These sessions focus on educating family members, addressing family dynamics, or preparing the family system for treatment. Documentation must relate family interventions back to the patient’s treatment plan.
CPT Code 90847 – Family Psychotherapy with Patient
This code represents family or couples therapy lasting approximately 50 minutes, where the patient is present. These sessions address relationship dynamics and communication patterns impacting the patient’s mental health when individual treatment alone proves insufficient.
Group and Specialized Services
CPT Code 90853 – Group Psychotherapy
This mental health CPT code applies to group treatment sessions lasting 45 to 60 minutes with 2 to 12 unrelated patients. Each sufferer makes their own claim. Providers must document group size, treatment interventions, and individual involvement to demonstrate medical necessity.
CPT Code 90875 – Psychophysiological Therapy
This specific code includes 30-minute sessions that combine psychotherapy and biofeedback approaches. While administering therapeutic procedures, providers use devices to monitor physiological responses such as heart rate and muscular tension. This code necessitates specialized training and monitoring equipment.
CPT Code 99404 – Preventive Medicine Counseling
This CPT code for mental health applies to 60-minute preventative counseling sessions that focus on behavioral health risk reduction rather than the treatment of diagnosed diseases. These sessions focus on prevention and health promotion through lifestyle changes and risk factor management.
Developmental and Behavioral Screening
CPT Code 96110 – Developmental Screening
This code relates to 10- to 15-minute developmental screenings that use standardized instruments like developmental milestone surveys or speech and language delay evaluations. The screening procedure includes administering, rating, and documenting the results to determine which children deserve a thorough developmental assessment. Providers must document which standardized instrument was used and maintain complete screening records.
CPT Code 96112 – Developmental Test Administration
This CPT code for mental health addresses comprehensive developmental testing conducted during the first 60 minutes by qualified healthcare professionals. The evaluation employs standardized measures to assess fine and gross motor skills, linguistic development, cognitive level, social functioning, memory, and executive function. The hour includes face-to-face test delivery, professional interpretation, and report writing.
CPT Code 96113 – Additional Developmental Testing
This add-on code tracks each 30-minute increment after the first hour of developmental test administration. Use 96112 when testing takes more than 60 minutes due to the necessity for extensive review. Each unit adds 30 minutes of face-to-face assessment and expert interpretation time. This code cannot be billed separately.
Brief Emotional and Behavioral Assessment
CPT Code 96127 – Brief Emotional/Behavioral Assessment
This code covers a brief emotional or behavioral assessment lasting approximately 5 to 10 minutes using standardized instruments like depression inventories or ADHD scales. The assessment includes administration, scoring, and documentation to identify patients needing a comprehensive psychological evaluation. Common instruments include the PHQ-9 for depression screening or the Vanderbilt scales for ADHD assessment.
Psychological and Neuropsychological Testing
CPT Code 96116 – Neurobehavioral Status Exam
This CPT code for mental health addresses clinical assessment of thinking, reasoning, and judgment conducted during the first 60 minutes by qualified healthcare professionals. The examination evaluates acquired knowledge, attention, language, memory, planning, problem-solving, and visual-spatial abilities. The hour includes face-to-face assessment time with patients and professional interpretation with comprehensive report preparation.
CPT Code 96121 – Additional Neurobehavioral Exam Time
This add-on code reports each additional 60-minute hour beyond the first hour of neurobehavioral status examination. Use with 96116 when assessment requires extended evaluation time due to case complexity or comprehensive examination needs. Each unit represents one additional hour of combined patient assessment and detailed report preparation time.
Mental Health CPT Codes – Quick Reference Table
Below is a quick reference guide with mental health CPT codes that are used throughout a typical workday:
| CPT Code | Service Description | Session Length |
| 90791 | Psychiatric Diagnostic Evaluation | 60 minutes |
| 90832 | Psychotherapy | 16-37 minutes |
| 90837 | Psychotherapy | 53+ minutes |
| 90838 | Psychotherapy with E/M | 60 minutes + E/M |
| 90839 | Crisis Psychotherapy | 30-74 minutes |
| 90846 | Family Therapy Without Patient | ~50 minutes |
| 90847 | Family Therapy With Patient | ~50 minutes |
| 90853 | Group Psychotherapy | 45-60 minutes |
| 90875 | Psychophysiological Therapy | ~30 minutes |
| 99404 | Preventive Counseling | 60 minutes |
Modifiers Used in Mental Health Billing
Modifiers work hand-in-hand with CPT codes for mental health to tell payers how you delivered care. Miss one, and your claim might get denied even though you coded everything else correctly.
Modifier 95 – Synchronous telemedicine
Append this to any audio or video telehealth session. Most payers won’t reimburse telehealth properly without it.
Modifier 93 – Audio-only telemedicine for phone sessions
Use this modifier. Mental health is one of the few specialties where audio-only still gets reimbursed, recognizing that not everyone has video access.
Modifier 25 – Separate E/M Service
This modifier is added to the E/M code when both medication management and psychotherapy are provided on the same day. It tells the payer these were two distinct services, not duplicate billing.
Common Mental Health Billing Challenges
Even experienced billers make costly mistakes with mental health CPT codes. Here’s what to watch for:
Time Code Errors
This happens all the time: providers pick the wrong code because they’re not tracking session length carefully. A 38-minute session needs the 38–52-minute code, not 90832, which only covers 16-37 minutes. One minute can make a difference.
Missing Modifiers
Failure to add Modifier 95 to your telehealth claim may result in denial. The same goes for missing Modifier 25 when you’re billing E/M and psychotherapy together; the payer will think you’re trying to double-bill.
Authorization Lapses
Many mental health services need prior authorization, and those authorizations expire. Set up a tracking system that alerts you before they run out; you’ll be filing claims that get denied for services you already provided.
Insufficient Documentation
Vague progress notes are a fast track to denials. Don’t just write “counseling provided.” Spell out what symptoms you addressed, what interventions you used, and how the patient responded.
Power up Your Mental Health Billing with Nexus io
Mental health CPT codes can cause serious trouble in your practice. Medical Billing becomes a full-time job when you factor in session length, modifiers, and the diversity of services offered in psychology, psychiatry, therapy, and counseling.
Nexus io provides mental health billing services exclusively to behavioral health providers. Our team has a strong grip on time-based codes, authorization tracking, and telehealth billing laws.
Our mental health billing services include certified coders, eligibility verification, authorization tracking, claim scrubbing, rejection management, and extensive reporting. We regularly exceeded 98% clean claim rates.
Contact Nexus io today if you’re a licensed mental health provider looking to streamline your billing operations and maximize reimbursement.
