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Mental Health Billing Services

Mental health billing requires mastering time-based psychotherapy codes, split-visit medication management, credentialing across multiple provider types, and payer-specific carve-out networks that differ from standard medical benefits.

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300+ Practices
90837Psychotherapy 53m
99213+E/M Add-on
90839Crisis Intervention
99492Collaborative Care

Why Mental Health Billing Requires Specialty Expertise

Mental health billing spans psychiatrists, psychologists, LCSWs, LPCs, and MFTs, each with distinct credentialing and reimbursement rules. Psychotherapy codes 90832, 90834, and 90837 are time-based, and documentation must reflect the exact session duration. Medication management adds E/M complexity when billed alongside therapy, and crisis intervention codes 90839-90840 require real-time documentation of each 30-minute increment.

Common Mental Health CPT Codes

Our coders handle these mental health codes daily. This is not an exhaustive list.

Code
Description
90791
Psychiatric diagnostic evaluation
90792
Psychiatric diagnostic evaluation with medical services
90832
Psychotherapy, 30 minutes
90834
Psychotherapy, 45 minutes
90837
Psychotherapy, 60 minutes
90847
Family psychotherapy with patient present
90853
Group psychotherapy
90839
Psychotherapy for crisis, first 60 minutes
99213
Established patient office visit, low MDM
99214
Established patient office visit, moderate MDM

2026 Medicare Allowables for Mental Health CPT Codes by State

Medicare reimbursement for mental 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 mental health CPT code pays a different amount in California than it does in Texas or Florida. The table below shows the 10 core mental 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.

2026 Medicare non-facility allowable for Mental Health CPT codes across high-volume states
CodeMental Health ProcedureCATXFLNYPAILOHGANCMI
90791Psychiatric diagnostic evaluation$185.78$173.32$174.13$184.81$173.64$172.91$169.49$171.63$170.13$170.91
90792Psychiatric 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
90832Psychotherapy, 30 minutes$91.80$85.85$86.23$91.43$86.02$85.67$84.04$85.05$84.33$84.71
90834Psychotherapy, 45 minutes$121.73$113.89$114.62$121.39$114.15$113.87$111.49$112.88$111.80$112.48
90837Psychotherapy, 60 minutes$178.57$167.03$167.77$177.86$167.37$166.70$163.52$165.48$164.08$164.83
90847Family psychotherapy with patient present$115.12$109.83$110.23$115.87$110.19$110.05$108.40$109.22$108.42$109.02
90853Group psychotherapy$32.45$30.38$30.73$32.46$30.46$30.52$29.73$30.14$29.76$30.06
90839Psychotherapy for crisis, first 60 minutes$171.44$160.29$161.41$170.95$160.66$160.31$156.87$158.87$157.30$158.31
99213Established 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
99214Established patient office visit, moderate MDM$148.01$134.59$140.26$148.05$135.13$137.84$129.83$133.55$129.44$133.44

Full Mental Health fee detail by state

2026 Medicare allowables for mental health CPT codes in California, processed under Noridian Healthcare Solutions (Jurisdiction E). See California medical billing.

2026 Medicare allowables for Mental Health CPT codes in California
CodeDescriptionNon-FacilityFacility
90791Psychiatric diagnostic evaluation$185.78$143.10
90792Psychiatric diagnostic evaluation with medical services$214.99$164.40
90832Psychotherapy, 30 minutes$91.80$72.44
90834Psychotherapy, 45 minutes$121.73$95.65
90837Psychotherapy, 60 minutes$178.57$141.02
90847Family psychotherapy with patient present$115.12$107.22
90853Group psychotherapy$32.45$25.34
90839Psychotherapy for crisis, first 60 minutes$171.44$135.07
99213Established patient office visit, low MDM$104.31$59.65
99214Established patient office visit, moderate MDM$148.01$87.54

Source: 2026 Medicare Physician Fee Schedule, locality-adjusted by state MAC. Figures are for reference and contracting benchmarks, not a guarantee of payment.

Mental Health Billing Challenges We Solve

Common billing problems in mental health and how our team handles them.

Time-Based Code Selection

Psychotherapy codes 90832 (16-37 min), 90834 (38-52 min), and 90837 (53+ min) require precise session-time documentation to avoid downcoding.

Split-Visit Billing

Psychiatrists providing both E/M and psychotherapy in the same visit must use add-on codes 90833/90836/90838 appended to the E/M code.

Provider-Type Credentialing

LCSWs, LPCs, and MFTs have varying reimbursement eligibility by payer and state, creating credentialing gaps that block claims.

Behavioral Health Carve-Outs

Many payers route mental health claims through carve-out networks (Optum Behavioral, Carelon) with separate credentialing and authorization rules.

Common Mental Health Denial Reasons

We prevent these before submission and appeal aggressively when they occur.

!
Psychotherapy codes 90832 (16-37 min), 90834 (38-52 min), and 90837 (53+ min) require precise session-time documentation to avoid downcoding
!
Psychiatrists providing both E/M and psychotherapy in the same visit must use add-on codes 90833/90836/90838 appended to the E/M code
!
LCSWs, LPCs, and MFTs have varying reimbursement eligibility by payer and state, creating credentialing gaps that block claims
!
Many payers route mental health claims through carve-out networks (Optum Behavioral, Carelon) with separate credentialing and authorization rules

Revenue Opportunities Most Mental Health Practices Miss

Mental health practices lose $50,000 to $150,000 annually through psychotherapy code downcoding alone. When therapists consistently bill 90834 (38-52 minutes, ~$95 Medicare) instead of 90837 (53+ minutes, ~$135 Medicare) because session documentation lacks exact times, the $40-per-visit difference across 25 patients per day adds up to $200,000+ in missed revenue per provider per year. Collaborative care codes 99492-99494 represent an additional untapped stream — practices with integrated behavioral health models can bill $140-165 per patient per month for psychiatric consultation time. Crisis intervention billing is another major gap. Codes 90839 and 90840 reimburse at higher rates than standard psychotherapy, yet many practices bill crisis sessions under standard therapy codes because staff are unfamiliar with the documentation requirements. A single properly coded crisis session bills $250-350 compared to $95-135 for standard therapy.

Payer-Specific Mental Health Billing Tips

Medicare reimburses psychotherapy at predictable rates under the Physician Fee Schedule, but reimbursement for non-physician providers (LCSWs, psychologists) is reduced to 75-85% of the physician rate. Medicare also covers collaborative care codes 99492-99494 for practices meeting CoCM model requirements, which many practices overlook. UnitedHealthcare routes all behavioral health claims through Optum Behavioral Health, requiring separate credentialing and prior authorization for intensive services. Anthem BCBS uses Carelon (formerly Beacon Health) for behavioral health management. Aetna manages behavioral health in-house but requires prior auth for any session beyond 30 visits per year. Cigna's Evernorth behavioral network has its own fee schedule that typically reimburses 10-15% below standard commercial rates. We track each carve-out's credentialing, auth requirements, and appeal processes.

Mental Health Billing Best Practices

Practical tips from our coding team to maximize reimbursement and minimize denials.

1
Document exact session start and stop times for every psychotherapy visit — payers audit time-based codes, and a 52-minute session billed as 90837 (53+ minutes) will be downcoded to 90834 with a $30-50 per-visit revenue reduction.
2
For psychiatrists performing medication management and psychotherapy in the same visit, bill the E/M code (99213-99215) as the primary service with the psychotherapy add-on (90833, 90836, or 90838) — never bill standalone psychotherapy codes for split visits.
3
Crisis intervention code 90839 covers the first 30-74 minutes and 90840 covers each additional 30-minute block. Document the clinical necessity and time spent in real-time notes.
4
Collaborative care codes 99492 (initial 70+ min/month) and 99493 (subsequent 60+ min/month) capture psychiatric consultation delivered through a primary care model — these are frequently missed in integrated-care practices.
5
Verify whether each payer routes behavioral health through a carve-out (Optum, Carelon, Beacon) before submitting claims. Sending claims to the wrong entity causes preventable denials.

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What We Handle for Mental Health Practices

Psychotherapy coding (90832, 90834, 90837)
Medication management and E/M+psychotherapy add-on billing
Crisis intervention coding (90839-90840)
Collaborative care management (99492-99494)
Multi-provider credentialing (LCSW, LPC, MFT, PsyD, MD)
Behavioral health carve-out network management
Prior authorization for intensive outpatient programs
Telehealth modifier application for virtual sessions

Why Choose Go Medical Billing for Mental Health

General billers routinely lose mental health revenue by defaulting to mid-level psychotherapy codes and missing add-on opportunities. Our coders specialize in time-based therapy coding, split-visit psychiatry billing, and behavioral health carve-out navigation.

We serve mental 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.

Mental Health Billing by State

We handle mental health billing in all 50 states. The 2026 Medicare allowables for mental 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.

CaliforniaTexasFloridaNew YorkPennsylvaniaIllinoisOhioGeorgiaNorth CarolinaMichiganNew JerseyVirginiaMassachusettsArizonaTennesseeMarylandIndianaMissouriWisconsinColorado
View all 50 states

Related Resources

Medical Billing & Coding ServicesA/R Recovery ServicesCredentialing & ContractingCase Studies & ResultsPricing

Frequently Asked Questions

Yes. We credential and bill for all mental health provider types including LCSWs, LPCs, MFTs, PsyDs, and psychiatrists. Each has different payer-eligibility rules, and we verify coverage before submitting claims.
We identify which payers route mental health through carve-out networks like Optum Behavioral Health, Carelon, or Evernorth, credential providers with each network, and submit claims to the correct entity to prevent denials.

Get Expert Mental Health Billing Support

Stop losing revenue to mental health coding errors and preventable denials. Call 888-701-6090 for a free billing assessment.

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