Behavioral Health Billing Services
Session-based coding, authorization tracking, telehealth modifiers, incident-to billing. We handle all of it.
Why Behavioral Health Billing Requires Specialty Expertise
Behavioral health billing involves session-based CPT codes with strict time documentation, payer-specific authorization rules, telehealth modifier complexity, and provider type restrictions.
Common Behavioral Health CPT Codes
Our coders handle these behavioral health codes daily. This is not an exhaustive list.
2026 Medicare Allowables for Behavioral Health CPT Codes by State
Medicare reimbursement for behavioral healthprocedures is not a single national number. Each code's allowable is adjusted by your state's Geographic Practice Cost Index (GPCI) and processed under that state's Medicare Administrative Contractor (MAC), so the same behavioral health CPT code pays a different amount in California than it does in Texas or Florida. The table below shows the 10 core behavioral healthcodes our coders bill priced at each state's 2026 locality. The non-facility figure is what an office-based practice collects. The facility figure applies when the service is performed in a hospital-based setting.
Commercial carriers in each state typically reimburse above these Medicare benchmarks and state Medicaid below them, but the Medicare allowable is the contracting anchor every payer negotiation starts from. Compare any individual code across all states with our Medicare fee calculator by state.
| Code | Behavioral Health Procedure | CA | TX | FL | NY | PA | IL | OH | GA | NC | MI |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 90791 | Psychiatric diagnostic evaluation | $185.78 | $173.32 | $174.13 | $184.81 | $173.64 | $172.91 | $169.49 | $171.63 | $170.13 | $170.91 |
| 90792 | Psychiatric diagnostic evaluation with medical services | $214.99 | $201.54 | $207.64 | $217.34 | $202.54 | $205.80 | $197.12 | $200.75 | $196.18 | $200.88 |
| 90832 | Psychotherapy, 30 minutes | $91.80 | $85.85 | $86.23 | $91.43 | $86.02 | $85.67 | $84.04 | $85.05 | $84.33 | $84.71 |
| 90834 | Psychotherapy, 45 minutes | $121.73 | $113.89 | $114.62 | $121.39 | $114.15 | $113.87 | $111.49 | $112.88 | $111.80 | $112.48 |
| 90837 | Psychotherapy, 60 minutes | $178.57 | $167.03 | $167.77 | $177.86 | $167.37 | $166.70 | $163.52 | $165.48 | $164.08 | $164.83 |
| 90838 | Psychotherapy, 60 min add-on to E/M | $144.99 | $136.27 | $140.53 | $146.87 | $136.99 | $139.34 | $133.42 | $135.84 | $132.68 | $135.98 |
| 90847 | Family psychotherapy with patient present | $115.12 | $109.83 | $110.23 | $115.87 | $110.19 | $110.05 | $108.40 | $109.22 | $108.42 | $109.02 |
| 90853 | Group psychotherapy | $32.45 | $30.38 | $30.73 | $32.46 | $30.46 | $30.52 | $29.73 | $30.14 | $29.76 | $30.06 |
| 96130 | Psychological testing evaluation, first hour | $132.10 | $123.62 | $126.88 | $133.14 | $124.17 | $125.76 | $120.86 | $123.00 | $120.46 | $122.98 |
| 99213 | Established patient office visit, low MDM | $104.31 | $94.46 | $98.20 | $103.97 | $94.79 | $96.44 | $90.97 | $93.60 | $90.84 | $93.44 |
Full Behavioral Health fee detail by state
2026 Medicare allowables for behavioral health CPT codes in California, processed under Noridian Healthcare Solutions (Jurisdiction E). See California medical billing.
| Code | Description | Non-Facility | Facility |
|---|---|---|---|
| 90791 | Psychiatric diagnostic evaluation | $185.78 | $143.10 |
| 90792 | Psychiatric diagnostic evaluation with medical services | $214.99 | $164.40 |
| 90832 | Psychotherapy, 30 minutes | $91.80 | $72.44 |
| 90834 | Psychotherapy, 45 minutes | $121.73 | $95.65 |
| 90837 | Psychotherapy, 60 minutes | $178.57 | $141.02 |
| 90838 | Psychotherapy, 60 min add-on to E/M | $144.99 | $113.77 |
| 90847 | Family psychotherapy with patient present | $115.12 | $107.22 |
| 90853 | Group psychotherapy | $32.45 | $25.34 |
| 96130 | Psychological testing evaluation, first hour | $132.10 | $103.24 |
| 99213 | Established patient office visit, low MDM | $104.31 | $59.65 |
Source: 2026 Medicare Physician Fee Schedule, locality-adjusted by state MAC. Figures are for reference and contracting benchmarks, not a guarantee of payment.
Behavioral Health Billing Challenges We Solve
Common billing problems in behavioral health and how our team handles them.
Session Limit Tracking
Payers impose session limits. Missing re-auth means denied claims.
Telehealth Modifiers
Rules vary by payer, state, and service type.
Provider Type Restrictions
LCSWs, LPCs, MFTs each have different billing rules.
Psych Testing Coding
96130-96139 series with strict time documentation.
Common Behavioral Health Denial Reasons
We prevent these before submission and appeal aggressively when they occur.
Revenue Opportunities Most Behavioral Health Practices Miss
Payer-Specific Behavioral Health Billing Tips
Behavioral Health Billing Best Practices
Practical tips from our coding team to maximize reimbursement and minimize denials.
Get Expert Behavioral Health Billing Support
Free billing assessment for your behavioral health practice. See where revenue is leaking.
What We Handle for Behavioral Health Practices
Why Choose Go Medical Billing for Behavioral Health
We track authorized sessions in real-time and handle the telehealth modifier complexity across all payers.
We serve behavioral health practices in all 50 states, starting at 2.49% of collections. Our credentialing team handles payer enrollment, and our A/R specialists recover aging claims.
Behavioral Health Billing by State
We handle behavioral health billing in all 50 states. The 2026 Medicare allowables for behavioral health CPT codes in every state are in the fee table above. Open any state below for its full payer environment, Medicaid rules, and Medicare MAC policies.
Frequently Asked Questions
Get Expert Behavioral Health Billing Support
Stop losing revenue to behavioral health coding errors and preventable denials. Call 888-701-6090 for a free billing assessment.