CPT Codes for Therapists: The 2026 Reference Guide

Every CPT code a solo therapist needs to know — what they mean, when to use them, and the documentation requirements that keep claims paid.

CPT codes are the language of insurance billing. Every claim you submit to a commercial payer, Medicare, or Medicaid is anchored to a specific CPT code that defines what service you provided, how long it took, and what documentation is required. Use the wrong code and you either underbill (losing income) or overbill (risking audit and recoupment).

This guide walks through the CPT codes most relevant to solo mental health practitioners — what each one means, when to use it, and what your documentation must include to support it. If you've ever wondered whether a 47-minute session is a 90834 or a 90837, this is the article for you.

A quick orientation

CPT codes (Current Procedural Terminology) are maintained by the American Medical Association. They're updated annually, typically with changes effective January 1. For mental health, the most commonly used codes fall in the 90791–90899 range.

Each CPT code has two pieces of information that matter for documentation:

• •Service definition — what the code represents
• •Time component — how long the service must take to qualify

Insurance audits frequently target time documentation. If a 90837 (60-minute session) note has nothing indicating that the session actually lasted 53+ minutes, the claim can be downcoded or denied.

The core therapy codes

These are the codes most solo therapists use 90% of the time.

90791 — Psychiatric diagnostic evaluation

What it is: An intake/initial diagnostic evaluation. This is the first session with a new client.

Time component: Typically 60–90 minutes; no strict time requirement, but should be substantial.

Documentation requirements:

• •Presenting concerns and history of present illness
• •Past psychiatric history
• •Past medical history relevant to mental health
• •Family psychiatric history
• •Social history (relationships, work, substance use, trauma history)
• •Mental status examination
• •Risk assessment
• •Initial diagnostic impressions (with DSM-5-TR codes)
• •Initial treatment recommendations

Common usage: Bill this once per client at the start of treatment. Many payers will only reimburse one 90791 per client per year except in unusual circumstances.

Rate: Typically the highest-reimbursed code in the therapy set. Use it.

90832 — Individual psychotherapy, 30 minutes

What it is: A short individual psychotherapy session.

Time component: 16–37 minutes of face-to-face time

Documentation requirements:

• •Session content and themes
• •Interventions used
• •Client response to interventions
• •Progress toward treatment goals
• •Plan for next session

Common usage: Brief check-in sessions, medication management collaborations with prescribers, child therapy where shorter sessions are clinically appropriate.

90834 — Individual psychotherapy, 45 minutes

What it is: The most common "standard" therapy session length for insurance billing.

Time component: 38–52 minutes of face-to-face time

Documentation requirements:

• •Same as 90832, but with greater clinical detail expected
• •Should clearly support medical necessity for ongoing treatment

Common usage: Standard weekly therapy session, especially when a session runs 45–52 minutes. Many therapists default to this code for sessions that don't quite hit the 53-minute threshold for 90837.

90837 — Individual psychotherapy, 60 minutes

What it is: The longer standard therapy session.

Time component: 53+ minutes of face-to-face time

Documentation requirements:

• •Detailed documentation supporting the longer session length
• •Clear clinical justification (complex trauma work, crisis intervention, intensive therapy modalities like EMDR)
• •Same elements as 90834 but more substantive

Common usage: The default for many therapists who do 50- or 55-minute sessions. Pays substantially more than 90834. Some payers audit 90837 usage more aggressively, so documentation must clearly support time spent.

Caution: Time is from start of session to end, not from when the client arrives. Late starts that result in 50-minute actual session time mean a 90834, not a 90837.

90847 — Family/couples therapy with patient

What it is: Family or couples therapy session with the identified client present.

Time component: 26+ minutes face-to-face

Documentation requirements:

• •Identified client (the patient with the diagnosis) and their family/partner present
• •Diagnosis must be the identified client's diagnosis
• •Treatment must focus on the identified client's clinical issues
• •Session content and family dynamics observed
• •Interventions used
• •Progress toward goals
• •Plan

Common usage: Couples therapy where one partner is the identified client; family therapy where the focus is on a particular family member's clinical issues.

Important nuance: Both partners cannot be the identified client. One must be designated as the patient for billing purposes. Some couples therapy doesn't qualify for insurance because there's no individual diagnosis to anchor it.

90846 — Family therapy without patient

What it is: Family therapy with family members but without the identified client present.

Time component: 26+ minutes

Documentation requirements:

• •Family members present (and which ones)
• •Focus on the identified client's treatment despite absence
• •Therapeutic rationale for meeting without the client
• •Session content and family dynamics

Common usage: Parents of a teen client, family members of an adult client struggling with substance use. Less commonly used than 90847.

90853 — Group psychotherapy

What it is: Therapy delivered in a group format.

Time component: No strict time requirement; document session length

Documentation requirements:

• •Group composition and size
• •Group focus and theme
• •Each member's participation and clinical content (separate notes per group member)
• •Interventions used
• •Each member's progress toward their individual treatment goals

Common usage: Process groups, psychoeducational groups, skills groups (DBT, parenting). Lower per-session reimbursement but spread across multiple clients.

Add-on and modifier codes

90785 — Interactive complexity add-on

What it is: An add-on code for sessions involving specific complications that increase the work involved.

When to use:

• •Communication difficulties (e.g., need for an interpreter)
• •Caregiver involvement that complicates treatment
• •Third-party complications (e.g., school or legal system involvement)
• •Use of play equipment or other communication aids with children

Documentation requirements:

• •Specific complicating factor present
• •How it increased the complexity of the session
• •Additional time or interventions required

This code is under-used by many therapists. If you do child therapy with parent involvement, custody-related work, or work with non-English-speaking clients, 90785 often applies.

90839 — Psychotherapy for crisis, first 60 minutes

What it is: Crisis intervention session.

Time component: 30–74 minutes

Documentation requirements:

• •Acute crisis presentation (suicidal ideation, acute severe distress, psychiatric emergency)
• •Mobilization of crisis resources
• •Risk assessment in detail
• •Safety planning
• •Coordination with other providers, family, or crisis services as needed
• •Clinical justification for crisis-level intervention vs. standard session

90840 — Psychotherapy for crisis, additional 30 minutes

Add-on code billed with 90839 when the crisis session extends beyond 74 minutes.

Codes by setting

Telehealth modifiers

For 2026, telehealth billing rules have stabilized:

• •GT modifier — generally no longer required by most commercial payers (was deprecated)
• •95 modifier — used for synchronous audio/video telehealth
• •POS (Place of Service) 10 — telehealth provided to patient in their home
• •POS 02 — telehealth provided to patient at a non-home location

Always check the specific payer's current telehealth billing requirements; they vary.

Audio-only sessions

Some payers (and Medicare for certain situations) accept audio-only telehealth. This typically requires:

• •POS 10 or POS 02
• •93 modifier for audio-only telehealth
• •Documentation justifying why video wasn't feasible (technical issues, accessibility, client preference)

Audio-only reimbursement is sometimes lower than video and is not accepted by all payers for all services.

Diagnoses must match the codes

CPT codes describe what you did. ICD-10 codes describe why. Every claim needs both, and they must be coherent.

A few diagnoses commonly used in therapy:

• •F32.x — Major Depressive Disorder, single episode
• •F33.x — Major Depressive Disorder, recurrent
• •F41.1 — Generalized Anxiety Disorder
• •F41.0 — Panic Disorder
• •F43.10 — Post-Traumatic Stress Disorder, unspecified
• •F43.12 — PTSD, chronic
• •F43.21 — Adjustment disorder with depressed mood
• •F43.22 — Adjustment disorder with anxiety
• •F43.23 — Adjustment disorder with mixed anxiety and depressed mood
• •F60.x — Personality disorders (use specific subtypes)
• •F90.x — ADHD
• •Z63.0 — Relationship distress with spouse/partner (often used in couples work)

The diagnosis must be supported by the clinical documentation. Coding F32.2 (severe major depression) for a client whose notes consistently document mild anxiety symptoms will not survive an audit.

The audit-readiness checklist

To make every CPT-coded claim audit-defensible, your note should include:

• •Date and start/end times — supports time-based coding
• •Place of service — office, telehealth-home, telehealth-other
• •Modality — in-person, video, audio-only
• •Participants — for couples/family sessions, who was present
• •Session content — what was discussed, in clinically meaningful detail
• •Interventions — what you specifically did
• •Client response — how the client engaged with interventions
• •Risk assessment — when relevant or for high-risk clients, every session
• •Progress — toward treatment plan goals
• •Plan — for next session, including homework
• •Diagnosis — current and supported by content
• •Medical necessity — clearly documented for ongoing treatment

Common coding mistakes

Using 90837 when the session was 50 minutes

A 50-minute session is a 90834. Coding it as 90837 is upcoding, even if your scheduled length is "60 minutes." Document actual session length.

Not billing 90791 for new clients

Many therapists default to 90834 for new client sessions because that's their standard code. The first session should almost always be 90791, which pays more and accommodates the longer intake conversation.

Missing 90785 opportunities

Especially with child clients, custody-involved cases, and clients needing interpreter services — 90785 is appropriate and adds reimbursement.

Coding by clinical fit vs. payer rules

Some payers won't pay for 90837 routinely. Some pay 90832 differently than commercial guidelines suggest. Know each payer's quirks for the codes you bill most often.

Not updating with annual CPT changes

CPT codes change annually, effective January 1. Each year, check for updates and adjust your standard codes if anything has changed.

The software factor

Modern practice management platforms reduce CPT coding errors dramatically by:

• •Pre-populating common codes by session type
• •Linking session length to appropriate code automatically
• •Flagging mismatches between code and documentation
• •Maintaining current CPT updates without requiring you to research them
• •Auto-populating modifiers based on session modality

Manual coding works, but it's a frequent source of revenue leakage and audit risk. If you're billing insurance with any volume, a platform built for solo therapists pays for itself in correctly-coded claims alone.

The bigger picture

CPT coding feels arcane until you understand it — and then it's just another professional skill, like learning how to write a treatment plan or how to handle a difficult intake. The therapists who get this right are paid fully for the work they do. The ones who don't lose income year after year to under-coded sessions and denied claims they don't have time to appeal.

If you're billing insurance, mastering CPT codes isn't optional. It's part of running a viable practice.

Want a practice management platform that handles CPT coding, documentation, and compliance automatically? Tendly is built for solo therapists who don't want to spend their evenings decoding billing rules. Start your free trial.