‍This article is co-authored by Headway

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If you’re a therapist planning to bill insurance companies, you need to wrap your head around CPT codes. Using the correct codes for psychotherapy when you bill ensures you’re reimbursed correctly and on time. 

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You don’t need to memorize these therapy codes, but you should at least get familiar with the ones you most frequently use. It will speed up the form-filling process and help you catch errors before you bill.

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It’s important to use the therapy code that most accurately reflects the time you spent with the patient to treat their condition, and ensure that documentation for the session supports the chosen code.

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These same codes apply whether you bill insurance directly or give clients a superbill to seek reimbursement on their own. If you're weighing whether to join insurance panels at all, our Complete Guide to Out-of-Network Billing for Therapists breaks down how that process works. Here’s everything you need to know about therapy billing codes, and the ones most common for therapy practices.

What are CPT codes?

CPT stands for Current Procedural Terminology. These therapy procedure codes are created and maintained by the American Medical Association (AMA). They’re used to track different types of medical services across medical fields, including mental health, to make sure clients and insurance companies are billed correctly. 

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CPT codes are five characters long. Typically that means five digits, but occasionally they are four digits and one number.

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Some codes have modifiers designated by a dash (-), which alter an already-existing code. For instance “-95” is a common therapy add-on code used as a modifier for telehealth services.

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Other codes are preceded with a plus sign (+), indicating that they’re add-on codes. These add-ons typically change the way an existing code is billed, for instance specifying that a particular service was provided outside of normal operating hours.

2026 therapy CPT codes and reimbursement rates

The CPT codes listed below are those most commonly used by therapy practices. Psychiatrists use a different set of codes.

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The typical reimbursement rate listed for each of these codes is based on data from the Centers for Medicare and Medicaid Services (CMS). Each fee is current as of 2026 and represents a national average.

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Your particular reimbursement rate may vary based on where your practice is located. For more precise information, use the CMS Medicare Physician Fee Schedule tool and provide your locality.

90791: Psychiatric diagnostic evaluation (without medical services)

2026 Medicare reimbursement rate: $174.50

Untimed, telehealth eligible

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You can use 90791 to bill for your initial evaluation of a new client if you’re not providing medical services (prescribing providers can use 90792). It’s typically reimbursed by insurance at a higher rate than 90837 or 90834. Typically, Medicare allows you to bill for this service once per client per year. Private insurers may allow you to bill once per six months; it varies according to the insurer.

90837: 60-minute psychotherapy with patient

2026 Medicare reimbursement rate: $172.80

53+ minutes, telehealth eligible

The 90837 code is used for mental health treatment sessions lasting approximately one hour after the client has completed an initial evaluation. It includes a wide range of in-office treatments across many different modalities, and may be modified with add-on codes (see next section). 

90834: 45-minute psychotherapy with patient

2026 Medicare reimbursement rate: $134.25

38 – 52 minutes, telehealth eligible

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The 90834 code is used for mental health treatment sessions lasting approximately 45 minutes after the client has completed an initial evaluation. It includes a wide range of in-office treatments across many different modalities, and may be modified with add-on codes (see next section). 

90832: 30-minute psychotherapy with patient

2026 Medicare reimbursement rate: $81.50

16 – 37 minutes, telehealth eligible

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The 90832 code is used for mental health treatment sessions lasting approximately 30 minutes after the client has completed an initial evaluation. It includes a wide range of in-office treatments across many different modalities, and may be modified with add-on codes (see next section). 

90847: Family psychotherapy/conjoint psychotherapy with patient present, 50 minutes

2026 Medicare reimbursement rate: $145.60

26+ minutes, telehealth eligible

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The 90847 code is used for  approximately 50 minutes of couples or family counseling with the patient(s) present. The code is only billed once, to cover both clients, and typically reimburses at a higher rate to cover the cost of seeing both. 

90853: Group psychotherapy (other than family)

2026 Medicare reimbursement rate: $30.39 (per patient)

Telehealth eligible

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The 90853 code is used for group psychotherapy sessions typically 45 to 60 minutes in length. Sessions should include a maximum of 10 patients. Medicare allows you to bill this code once per day.

90839: Psychotherapy for crisis, 60 minutes

2026 Medicare reimbursement rate: $152.40

30 – 74 minutes, telehealth eligible

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The 90839 code is used for unscheduled therapy sessions of approximately 60 minutes when clients are facing crises. If you provide this service remotely (by phone or online conferencing), add the modifier “-95” (for video and audio) or “-93” (for audio only) to the code when billing. 

CPT add-on codes for therapists

CPT add-on codes modify codes you’re already using to report treatment when you bill insurance. For example, many add-on codes are used to report sessions that lasted longer than the original code indicates. 

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On bills, add-on codes are indicated with a plus (+) sign. 

90785: Interactive complexity

2026 Medicare reimbursement rate: $14.50

Untimed, telehealth eligible

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The 90785 add-on indicates sessions where there were difficulties in communication. 

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That could be because the client requested third parties (schools, social services) family members, or language interpreters to be present; is not legally responsible for their care (due to disability or status as a minor); struggled to communicate due to disability or the state of their mental health; required tools like toys or art supplies to communicate; or provided information you’re legally obligated to report to a third party.

90840: Additional 30 minutes’ crisis treatment, used with 90839

2026 Medicare reimbursement rate: $72.50

+30 minutes, telehealth eligible

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If you provide a client with unscheduled treatment due to a crisis and the session extends considerably beyond the 60 minute mark, use the 90840 code to report each additional 30 minutes.

CPT code billing examples for therapists

Here are two examples of how you might use CPT codes to bill for therapy services.

Example #1: Crisis call

Scenario

You receive an after-hours phone call from a juvenile therapy client who is experiencing a mental health crisis, and provide 55 minutes of care over the phone.

CPT codes and billing

To bill insurance, you would use these CPT codes:

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• 90839-93: This indicates that you provided between 30 and 74 minutes of crisis care. The -93 modifier is for telehealth using audio only (the phone call).
• 90785: This indicates interactive complexity—in this case, the fact that the client was a minor and not legally responsible for their care.

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When billing Medicare, assuming the average national Medicare rates for 2026 apply, your total reimbursement would be $166.90 ($152.40 for crisis care + $14.50 for interactive complexity).

Example #2: Assessment and treatment

Scenario

You meet a new client in person for intake. After their initial assessment is complete, you do a 30 minute talk therapy session. 

CPT codes and billing

To bill insurance, you would use these CPT codes:

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• 90791: For the initial evaluation.
• 90832: For the additional 30 minute session.

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When billing Medicare, assuming the average national Medicare rates for 2026 apply, your total reimbursement would be $266.65 ($174.50 for the initial assessment + $92.15 for the 30 minute session).

Example #3: Group therapy

Scenario

You lead a group therapy session with 6 members lasting 50 minutes.

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CPT codes and billing

To bill insurance, you would use just one CPT code six times:

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• 90853: For each client, you submit a claim using this code to indicate group therapy. 

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When billing Medicare for all six clients, assuming the average national Medicare rates for 2026 apply, your total reimbursement would be $182.34 (6 x $30.39)

Therapy CPT codes and prior authorization

Correct CPT codes for treatment are essential for getting prior authorization for treatment from insurance companies.

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To speed up prior authorization and avoid denials from insurance:

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• Make sure CPT codes match client ICD-10 codes. The treatment you’re providing or proposing to provide (indicated by the CPT code) must match the client’s ICD-10.
• Ensure therapy billing codes are in sync with approved treatment. For example, if insurance has approved a client for 45 minute sessions (CPT 90834), but you bill for 60 minute sessions (CPT 90837), your claim may be denied or downcoded (reduced to the appropriate rate).
• Double check your therapy add on codes. A small error with CPT code modifiers can result in a denial. For example, if you modify the code for a therapy session with “-95” instead of “-93”—indicating live video telehealth, rather than audio-only—and it does not fit within the insurer’s approved treatments, the claim may be denied.
  
  

For a full walkthrough of the claims process, from submission to handling denials and clawbacks, see our Complete Guide to Insurance Billing for Therapists.

Upcoding and downcoding for therapists

Upcoding and downcoding are two sides of the same coin. They’re both ways therapists and other medical health professionals sometimes inaccurately bill insurance companies by assigning the wrong codes for procedures.

Upcoding for therapy

Upcoding consists of assigning a more highly-reimbursed CPT code to a particular treatment than it merits. 

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Upcoding can be done fraudulently and intentionally, such as a therapist who uses 90837 on their bill when 90834 would be a more accurate code, in order to receive a higher reimbursement from the insurance company. 

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But upcoding may also be done unintentionally, such as billing for unnecessary medical services.

Downcoding for therapy

Downcoding is the opposite of upcoding. It consists of reporting a less extensive (and less highly reimbursed) form of treatment in place of one that’s more complex.

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 A therapist might do this in error, or they may do it because they’re worried about having their claims questioned by the insurance company, or because they’re trying to work around limits on how frequently units under a certain code may be billed. One example: The one-per-day limit on group psychotherapy billed to Medicare.

Accurate coding for therapy

Upcoding or downcoding may lead to audits of your practice by the insurance company, reimbursement takebacks, and charges of fraudulent billing. Your license to practice may be put in jeopardy. It’s best for the long-term health of your practice and your reputation as a professional to avoid inaccurate coding.

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New to running your own therapy practice? Here’s how to get credentialed with an insurance provider and here's everything you need to know about How to Start a Private Practice as a Therapist.

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Headway is a free service that makes it easier and more profitable for therapists and psychiatrists to accept insurance. From built-in client documentation, and scheduling to free CEUs and dedicated support, Headway provides the foundation you need to grow your insurance practice. Talk to a practice consultant to learn more.

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This post is to be used for informational purposes only and does not constitute legal, business, or tax advice. Each person should consult their own attorney, business advisor, or tax advisor with respect to matters referenced in this post.

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