Psychiatry CPT Codes 2026: The Definitive Guide & Cheat Sheet

If you've ever stared at a superbill wondering whether to bill 99214 or 99215 — or whether your 30-minute med check even qualifies for an add-on code — you're not alone. Psychiatry billing is genuinely complicated, and the rules keep shifting.

This guide cuts through the noise. Whether you're a solo psychiatrist, a prescribing PMHNP, or a billing manager at a group practice, here's everything you need to know about psychiatry CPT codes heading into 2026 — including rates, documentation requirements, common mistakes, and a cheat sheet you can actually use.

Why Psychiatry Billing Is Its Own Animal

Psychiatry occupies a unique billing lane. Unlike most specialties, psychiatrists can bill both Evaluation & Management (E/M) codes and psychiatric-specific codes — sometimes on the same date of service. That flexibility is powerful, but it also creates more opportunities to underbill, overbill, or simply code incorrectly.

Add in the fact that major payers like Cigna, Aetna, UnitedHealthcare, and BlueCross BlueShield each have their own coverage policies and medical necessity criteria, and you've got a billing environment that rewards the practitioners who actually understand the rules.

Let's start from the top.

The Two Major Code Categories for Psychiatry

1. Psychiatric Diagnostic Evaluation Codes

Used for initial assessments. These are typically billed once (sometimes twice for complex cases).

2. Psychiatric Therapeutic Procedure Codes

Used for ongoing treatment — psychotherapy, medication management, or both.

Beyond these, psychiatrists also frequently use E/M codes (the 99xxx series) when the visit focuses primarily on medical decision-making, and add-on codes to capture the full scope of a session.

The Master Cheat Sheet: Psychiatry CPT Codes for 2026

| CPT Code | Description | Typical Duration | 2025 Medicare Rate* | Notes | |---|---|---|---|---| | 90791 | Psychiatric diagnostic eval (no medical services) | 60–90 min | ~$162 | Initial intake; no Rx or medical review | | 90792 | Psychiatric diagnostic eval with medical services | 60–90 min | ~$218 | Includes prescribing/medical decision-making | | 90832 | Psychotherapy, 30 min | 16–37 min | ~$70 | Add-on eligible with E/M | | 90834 | Psychotherapy, 45 min | 38–52 min | ~$92 | Add-on eligible with E/M | | 90837 | Psychotherapy, 60 min | 53+ min | ~$134 | Most commonly billed therapy code | | 90839 | Psychotherapy for crisis, first 60 min | 30–74 min | ~$170 | Crisis only; strict documentation required | | 90840 | Psychotherapy for crisis, each additional 30 min | 30+ min | ~$83 | Add-on to 90839 | | 90833 | Psychotherapy add-on, 30 min (with E/M) | 16–37 min | ~$66 | Billed WITH 99xxx codes | | 90836 | Psychotherapy add-on, 45 min (with E/M) | 38–52 min | ~$87 | Billed WITH 99xxx codes | | 90838 | Psychotherapy add-on, 60 min (with E/M) | 53+ min | ~$125 | Billed WITH 99xxx codes | | 99202–99205 | New patient office visit (E/M) | Varies | ~$77–$211 | Complexity-based since 2021 | | 99211–99215 | Established patient office visit (E/M) | Varies | ~$24–$167 | MDM or time-based | | 99354–99355 | Prolonged services (outpatient) | 15+ min beyond | ~$33–$64 | Used when E/M time is exceeded | | 99446–99449 | Interprofessional telephone/internet consult | 5–30+ min | ~$18–$85 | Consulting psychiatrist bills these | | 99484 | General BHI care management, 20 min | Monthly | ~$49 | Collaborative care model | | 99492 | CoCM initial month (70 min) | First month | ~$302 | Collaborative Care Model | | 99493 | CoCM subsequent months (60 min) | Ongoing | ~$254 | Collaborative Care Model | | 96130–96133 | Psychological testing (eval + interpretation) | Per hour | ~$90–$135/hr | Neuropsych/psych testing | | 90853 | Group psychotherapy | 45–90 min | ~$31 | Each patient billed separately | | 90847 | Family therapy with patient present | 50–60 min | ~$109 | | | 90846 | Family therapy without patient present | 50–60 min | ~$100 | |

Medicare rates are approximate 2025 national averages. 2026 rates will be finalized in the CY2026 Physician Fee Schedule, typically released in November 2025. Commercial rates vary significantly by payer and contract.

Breaking Down the Most Billed Codes

90791 vs. 90792: Which Intake Code Do You Use?

This is one of the most common points of confusion — and one of the most audited.

Use 90791 when your intake is purely diagnostic — you're gathering history, formulating a diagnosis, and making a treatment plan without prescribing or providing medical services.

Use 90792 when the intake includes medical services — meaning you're reviewing labs, prescribing medication, assessing for medical contributors to psychiatric symptoms, or performing any level of medical decision-making.

If you're a psychiatrist who almost always considers medication at intake, 90792 is almost always your code. The reimbursement difference (~$56 more under Medicare) adds up fast, and it more accurately reflects the complexity of what you actually did.

Documentation must-haves for 90792:

Chief complaint and history of present illness
Mental status exam
Review of relevant medical history, medications, or labs
Psychiatric formulation and diagnosis
Medical decision-making element (even if you decide not to prescribe)
Treatment plan

The Add-On Code Goldmine: 90833, 90836, 90838

Here's where a lot of psychiatrists leave serious money on the table.

When a session includes both medication management (E/M) AND psychotherapy, you can bill an E/M code plus a psychotherapy add-on code. This is fully legitimate, widely accepted by payers, and specifically designed for psychiatrists.

Example: A 45-minute established patient visit where you spend 20 minutes on medication review/adjustment and 30 minutes on psychotherapy.

Bill: 99214 (E/M, established patient) + 90833 (psychotherapy add-on, 16–37 min)
Combined Medicare reimbursement: approximately $113–$135 vs. ~$87 for psychotherapy alone

The key rule: You must document both components separately. The E/M documentation must stand on its own (medical decision-making or total time), and the psychotherapy portion must be clearly noted as distinct therapeutic work.

Payers that commonly accept this combo: Medicare, Medicaid (most states), UnitedHealthcare, Aetna, Cigna. Always verify your specific contracts.

E/M Codes: Time vs. Medical Decision-Making (MDM)

Since the AMA's 2021 E/M overhaul, you have two ways to select your E/M level:

Option 1: Total Time on Date of Service Count all time you personally spent on that patient's care that day — face-to-face and non-face-to-face (reviewing records, ordering tests, documenting, care coordination).

| E/M Level | New Patient Time | Established Patient Time | |---|---|---| | 99202 / 99212 | 15–29 min | 10–19 min | | 99203 / 99213 | 30–44 min | 20–29 min | | 99204 / 99214 | 45–59 min | 30–39 min | | 99205 / 99215 | 60–74 min | 40–54 min |

Option 2: Medical Decision-Making (MDM) Based on the number and complexity of problems, the amount and complexity of data reviewed, and the risk of complications.

For psychiatry, time-based billing is often simpler and more defensible — especially when you're documenting medication management for complex patients with multiple comorbidities.

Collaborative Care Model (CoCM) Codes: The Underutilized Revenue Stream

If your practice participates in Collaborative Care — where a primary care provider, behavioral health care manager, and consulting psychiatrist work together — you're sitting on a significant billing opportunity that most practices ignore.

99492 (initial month) and 99493 (subsequent months) are billed by the primary care practice, but the consulting psychiatrist's time counts toward the monthly threshold. These codes reimburse $250–$300+ per patient per month under Medicare and most commercial plans.

If you're a psychiatrist providing caseload consultation in a CoCM arrangement, make sure the billing practice is capturing your consultation time and you have a clear contractual arrangement for your share of revenue.

Telehealth Psychiatry Codes in 2026

Good news: telehealth parity has been significantly expanded, and most major codes are billable via video for psychiatry.

What to know for 2026:

Medicare's telehealth flexibilities are expected to continue through at least 2026 under current legislative extensions
The GT modifier (or POS 02/10) is required for telehealth billing
Audio-only visits (telephone) have more restrictions — check payer-specific policies
State licensure requirements still apply — you must be licensed where the patient is located
Commercial payers vary widely: Cigna and Aetna have largely maintained telehealth parity; some regional BlueCross plans have rolled back certain codes

Always append the correct place of service code:

POS 02: Telehealth provided other than in patient's home
POS 10: Telehealth provided in patient's home

The 5 Most Common Psychiatry Billing Mistakes

1. Upcoding without documentation support Billing 99215 consistently without MDM or time documentation to support it is a fast track to a RAC audit. Your documentation has to match your code.

2. Missing the add-on code opportunity Not billing 90833/90836/90838 when both therapy and medication management occurred. Leaving $50–$100 per session on the table.

3. Using 90791 when 90792 is appropriate Prescribing psychiatrists conducting intakes almost always qualify for 90792. The documentation difference is minimal; the reimbursement difference is meaningful.

4. Incorrect time documentation for time-based E/M If you're billing on time, you must document the total time spent, not just face-to-face time. "30-minute session" doesn't cut it.

5. Not verifying payer-specific coverage Not all CPT codes are covered by all payers. Group therapy (90853), family therapy, and some add-on codes have variable coverage. Always verify before billing.

Documentation That Actually Protects You in an Audit

The best billing defense is documentation written at the time of service that tells a clear clinical story. For psychiatry, auditors are specifically looking for:

Medical necessity clearly stated — why this level of care, why this medication, why this frequency
Time documentation if using time-based E/M — specific total minutes
Separate documentation of E/M and psychotherapy components when billing add-ons
Mental status exam — surprisingly often missing or templated to meaninglessness
Treatment plan updates that reflect the actual clinical picture

This is exactly where AI-powered documentation tools like Mozu Health change the game. Instead of copying forward last week's note and hoping it holds up, Mozu generates structured, payer-aligned documentation that captures the clinical complexity you're actually delivering — in a fraction of the time.

FAQ: Psychiatry CPT Codes 2026

Q1: Can I bill both 90792 and an E/M code on the same day?

Generally, no. 90792 already includes medical services and is not typically billed alongside an E/M code on the same date of service. For ongoing visits where you're doing both medication management and psychotherapy, use an E/M code (99212–99215) with the appropriate psychotherapy add-on (90833, 90836, or 90838).

Q2: How often can I bill 90791 or 90792 for the same patient?

Most payers allow these codes once per episode of care (sometimes twice for complex evaluations). Some payers will allow re-evaluation after a significant gap in care — typically 3 years or more, but this varies by payer. Check your specific contracts.

Q3: Can NPs and PAs bill psychiatric CPT codes?

Yes. PMHNPs and PAs with prescriptive authority can bill psychiatric codes including 90792 and the E/M add-on combinations, as long as they are credentialed with the payer, practicing within their state's scope of practice, and billing under their own NPI. Incident-to billing rules may apply in some settings.

Q4: What's the difference between 90837 and billing 99214 + 90833?

Both can cover approximately 45–60 minutes of patient care. The difference is content. If the session is purely psychotherapy with no medication management or medical decision-making, bill 90837. If the session includes both therapy and medication-related work, bill the E/M + add-on combo — which typically reimburses more and more accurately reflects what you did.

Q5: Will 2026 bring significant changes to psychiatry CPT codes or Medicare rates?

The CY2026 Physician Fee Schedule will be proposed in summer 2025 and finalized around November 2025. Based on current CMS trends, expect modest rate adjustments (often slight reductions due to budget neutrality requirements) and possible updates to telehealth coverage policies. Watch for any changes to the collaborative care codes and any new guidance on audio-only telehealth. We'll update this guide as final rates are published.

Q6: Can I bill 90853 (group therapy) and individual therapy codes on the same day for the same patient?

Yes, in most cases — as long as both services were genuinely rendered and documented separately, and the total time is clearly documented. Some payers require a modifier (like 59) to indicate distinct services. Check payer-specific rules.

Q7: What modifier should I use for telehealth psychiatry billing?

For Medicare, use POS 02 (patient not at home) or POS 10 (patient at home). The GT modifier is used for Medicare Advantage and many commercial plans. Some payers also require the 95 modifier. Always check payer requirements — telehealth modifier requirements are one of the most frequent sources of claim denials.

Quick Reference: When to Use Which Code

| Clinical Scenario | Recommended Code(s) | |---|---| | First-time patient eval, prescribing psychiatrist | 90792 | | First-time patient eval, therapy-only provider | 90791 | | Established patient, medication only, 20 min | 99213 | | Established patient, medication only, 35 min | 99214 | | Established patient, med mgmt + 30 min therapy | 99214 + 90833 | | Established patient, med mgmt + 45 min therapy | 99214 + 90836 | | Crisis intervention, first hour | 90839 | | Crisis intervention, 90 minutes total | 90839 + 90840 | | Group session, 6 patients | 90853 × 6 (one claim per patient) | | Family session, patient present | 90847 | | Collaborative care consultation | 99446–99449 (consulting psychiatrist) |

The Bottom Line

Accurate psychiatry billing isn't about gaming the system — it's about getting paid fairly for the care you actually provide. Undercoding costs you real revenue. Overcoding without documentation puts your license and your practice at risk.

The answer is precise, contemporaneous documentation that reflects clinical reality. And in 2026, that's increasingly possible without the documentation burden that's been burning out clinicians for years.

Stop Leaving Money on the Table — Try Mozu Health

Mozu Health is an AI-powered clinical documentation platform built specifically for behavioral health. It helps psychiatrists, therapists, and group practices:

Generate HIPAA-compliant, audit-ready notes that align with the CPT code you're billing
Automatically flag add-on code opportunities you might be missing
Reduce documentation time by up to 60% so you can see more patients or reclaim your evenings
Stay compliant with payer-specific documentation requirements across Medicare, Medicaid, and commercial insurers

Whether you're a solo psychiatrist trying to stop copying forward old notes, or a group practice looking to tighten billing accuracy across your entire team — Mozu Health was built for exactly this.

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Disclaimer: CPT codes and reimbursement rates are subject to change. 2026 Medicare rates will be finalized in the CY2026 Physician Fee Schedule. Always verify current rates and payer-specific policies before submitting claims. This content is for educational purposes and does not constitute legal or billing advice.

Psychiatry CPT Codes 2026: Definitive Guide & Cheat Sheet