Cheat sheetUpdated October 12, 20264 min read

Behavioral health CPT and time cheat sheet

Time bands, add-on rules and common pitfalls for 90791, 90832/34/37, 90839/40, 90846/47, 90853, 90785 and the Medicaid H-codes — with a calculator that picks the code from minutes.

For: Clinicians, billers, compliance and revenue cycle teams

Minutes to code

Service

Face-to-face minutes

060120180 min

Interactive complexity presentMaladaptive communication, interfering caregiver, sentinel event, or play/interpreter for a non-verbal client.

Report

90837Psychotherapy, 60 minutes (53+ min)

90837 draws payer scrutiny. Record start and stop times.

Uses the same time rules as Margent's note checks. Payer rules can differ — this is a reference, not billing advice.

Diagnostic evaluation

Code	Service	Time	Notes
90791	Psychiatric diagnostic evaluation, no medical services	None in CPT	Payers often limit frequency (e.g., once per episode, or once per 6–12 months).
90792	Psychiatric diagnostic evaluation with medical services	None in CPT	Prescribers only. Includes medical assessment elements.

Psychotherapy codes are reported by face-to-face time with the patient and/or family member, and the patient must be present for all or part of the service. Since 2024, CPT time for these codes follows the midpoint rule: a unit of time is attained when the midpoint is passed.

Code	Nominal	Report when time is	With E/M instead use
—	—	Under 16 minutes	Not reportable as psychotherapy
90832	30 min	16–37 minutes	90833
90834	45 min	38–52 minutes	90836
90837	60 min	53 minutes or more	90838

Crisis psychotherapy

Code	Service	Time
90839	Psychotherapy for crisis, first 60 minutes	30–74 minutes
90840	Each additional 30 minutes (add-on to 90839)	+1 unit at 75 min, +2 at 105 min, and so on

Under 30 minutes of crisis psychotherapy: report the appropriate psychotherapy code (90832 or 90834) instead.
Do not report 90832–90838 or 90785 on the same date by the same clinician as 90839/90840.
Document the urgent assessment, history of the crisis, mental status exam, disposition, and interventions to mobilize resources and reduce distress. Exact total time is required.

Family and group

Code	Service	Time / notes
90846	Family psychotherapy without the patient present	50 min nominal; 26+ min to report
90847	Family psychotherapy with the patient present	50 min nominal; 26+ min to report
90849	Multiple-family group psychotherapy	Per family; on the Medicare telehealth list from CY2026
90853	Group psychotherapy (other than multiple-family)	Per member, per session; no CPT time requirement, but payers may cap group size

Family codes must be for the benefit of the identified patient's treatment. Group notes must individualize each member's participation and response — identical member text is treated as cloned documentation.

Interactive complexity (90785)

An add-on to 90791, 90792, 90832–90838 and 90853. Not with 90839/90840 or with E/M alone. Report it only when at least one of four factors is present and documented:

The need to manage maladaptive communication (high anxiety, reactivity, repeated questions or disagreement) among participants that complicates care.
Caregiver emotions or behaviors that interfere with implementing the treatment plan.
Evidence or disclosure of a sentinel event and mandated report to a third party (for example, abuse or neglect), with initiation of discussion of the event and report with the patient and others.
Use of play equipment, physical devices, an interpreter or translator to overcome barriers to communication with a patient who has not developed, or has lost, the expressive or receptive language skills needed to communicate.

Common Medicaid HCPCS codes

Medicaid programs and managed care plans use HCPCS Level II codes for many community services. Definitions, modifiers, credentials and unit rules vary by state — treat this table as a map, not a rulebook.

Code	Service	Unit
H0001	Alcohol and/or drug assessment	Per assessment
H0004	Behavioral health counseling and therapy	15 min
H0005	Alcohol and/or drug group counseling	Varies
H0015	Alcohol and/or drug intensive outpatient	Per diem (typically)
H0031	Mental health assessment by non-physician	Varies
H0032	Mental health service plan development by non-physician	Varies
H0035	Mental health partial hospitalization, less than 24 hours	Per diem
H0036	Community psychiatric supportive treatment	15 min
H0038	Self-help / peer services	15 min
H2011	Crisis intervention service	15 min
H2014	Skills training and development	15 min
H2017	Psychosocial rehabilitation services	15 min
H2019	Therapeutic behavioral services	15 min
T1017	Targeted case management	15 min

Many states use an 8-minute rule for 15-minute units: 8–22 minutes is one unit, 23–37 two units, and so on. Others require the full 15 minutes, or count cumulative minutes across a day. Configure it per payer, not per clinician.

Telehealth

Item	Use
POS 02	Telehealth provided other than in the patient's home
POS 10	Telehealth provided in the patient's home
Modifier 95	Synchronous audio-video telehealth (where the payer requires it)
Modifier 93	Synchronous audio-only telehealth
Modifier FQ	Service furnished using audio-only technology (Medicare, certain settings)

Medicare's in-person requirement for mental health telehealth has been delayed to January 1, 2028, and telehealth flexibilities run through the end of 2027. Commercial and Medicaid rules differ; check each payer.

Documentation that supports the code

Start and stop time (or total time) for every timed code
Psychotherapy time separate from E/M time when billing add-ons
The specific 90785 factor, in words, when it's reported
Exact total time and crisis elements for 90839/90840
Who was present for family codes; each member's response for group codes
Modality, place of service and consent for telehealth

Sources

01AMA CPT® Professional (psychiatry section)
02CMS, CY2026 Medicare Physician Fee Schedule final rule summary (MLN MM14315) (opens in a new tab)
03Consolidated Appropriations Act, 2026 (telehealth extensions)

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Behavioral health CPT and time cheat sheet

Minutes to code

Diagnostic evaluation

Individual psychotherapy

Crisis psychotherapy

Family and group

Interactive complexity (90785)

Common Medicaid HCPCS codes

Telehealth

Documentation that supports the code

Sources

Run these checks on every note, automatically.

Behavioral health CPT and time cheat sheet

Minutes to code

Diagnostic evaluation

Individual psychotherapy

Crisis psychotherapy

Family and group

Interactive complexity (90785)

Common Medicaid HCPCS codes

Telehealth

Documentation that supports the code

Sources

Run these checks on every note, automatically.