What is the difference between 90834 and 90837?

CPT 90834 bills psychotherapy with the patient for 38 to 52 minutes; CPT 90837 bills psychotherapy for 53 minutes or more. Both describe outpatient individual psychotherapy without medical evaluation and management. Many payers scrutinize 90837 utilization more heavily and may require additional documentation justifying the longer session. The actual face-to-face time, not the scheduled appointment block, determines which code applies.

Can a therapist bill 96127 in the same visit as 90834?

Yes. CPT 96127 is an add-on style code reimbursed in addition to the primary psychotherapy or evaluation code. A common pattern is 90834 (psychotherapy, 45 minutes) plus 96127 x 2 units for PHQ-9 and GAD-7 scored in that visit. Each 96127 unit billed must have the scale name, score, and clinical interpretation documented. Up to 4 units of 96127 are reimbursable per encounter.

Who can bill mental health CPT codes?

Eligibility is set by payer enrollment rules and state licensure scope. CPT 90832, 90834, 90837, 90847, and 96127 are typically billable by licensed psychologists, LCSW or LICSW, LMFT, LPC or LPCC, psychiatric nurse practitioners, and physicians. CPT 90791 is billable by most of the above but excluded for some prescribing-only visits where 90792 (with medical service) applies. Always verify enrollment with each payer.

Mental Health Billing Codes

Q: What CPT code is used to bill PHQ-9 or GAD-7 administration?

CPT 96127 (Brief emotional/behavioral assessment, with scoring and documentation, per standardized scale). Bills validated brief screeners including PHQ-9, GAD-7, PCL-5, AUDIT, ASRS, MDQ, SCARED. Up to 4 units per visit. Reimbursement is typically $4–6 per unit and compounds across patient panels. See the calculator below for projections.

Q: What ICD-10 codes are most common in therapy billing?

F33.1 (Major Depressive Disorder, Recurrent, Moderate), F41.1 (Generalized Anxiety Disorder), F43.10 (PTSD, Unspecified), F90.0 (ADHD, Predominantly Inattentive), F31.81 (Bipolar II), F50.81 (Binge Eating Disorder), and F60.3 (Borderline Personality Disorder) are among the most frequently used. Each ICD-10 detail page on this site documents DSM-5-TR criteria and the validated screener that supports the diagnosis.

Q: Do I need both an ICD-10 and a CPT code on every claim?

Yes, on most behavioral health claims. The CPT code drives reimbursement (what was done); the ICD-10 code establishes medical necessity (why it was done). A claim with only one is typically denied. The exception is some non-clinical services that don't require a diagnosis pointer.

Q: How much does mental health billing reimburse?

Reimbursement varies substantially by payer, state, and contract. Approximate national medians: 90834 psychotherapy ~$95–140, 90837 ~$130–180, 90791 evaluation ~$140–200, 96127 brief assessment ~$4–6 per unit (up to 4 units), 99214 E/M ~$120–170. Verify with your specific payer fee schedules. The CPT 96127 calculator below models cumulative effects across patient panels.

Plain-language reference for therapy and behavioral health billing. CPT codes for the service performed, ICD-10 codes for the diagnosis treated. Reimbursement guidance, common pairings, and a 96127 calculator that turns brief-assessment billing into a real revenue projection.

Scope: United States. Codes covered are ICD-10-CM (US clinical modification) and AMA CPT, both US-specific. Other countries use different systems: Canada uses ICD-10-CA + provincial billing codes (OHIP, MSP, RAMQ, etc.); the UK uses NHS billing on top of WHO ICD-10; Australia uses MBS item numbers + ICD-10-AM. CPT is licensed only in the U.S.

Reimbursement is approximate. Amounts are national medians for U.S. commercial payers; Medicare rates are public via the CMS Physician Fee Schedule. State Medicaid rates and commercial contract rates vary substantially. Verify with your specific payer fee schedules before billing.

96127 reimbursement calculator

CPT 96127 bills brief-scale administration (PHQ-9, GAD-7, etc.). Per-unit reimbursement is small; cumulative effect across a patient panel is material. Adjust the inputs to your practice.

CPT 96127 estimator

Annual MBC reimbursement projection

Quick model of what brief-assessment billing yields across a panel. Adjust inputs to your practice.

Active patient panel% receiving MBC scalesScales administered / visit (max 4)Sessions / patient / monthReimbursement per unit ($USD, payer-specific)Typical range $4–$6. Verify with your specific payer fee schedules.

Per visit

$10

Per month

$700

70 admins

Annualized

$8,400

Estimator uses average values; actual reimbursement varies by payer mix, denials, and visit cadence. CPT 96127 has a documentation requirement (validated scale, scoring, clinical interpretation in the note) that must be met for each unit billed.

Code lookup

Search any code, diagnosis, scale, or service name. Both CPT and ICD-10 lists filter live. Choose a country to see what coding system applies, currently only U.S. codes are catalogued in this hub.

CPT codes (services)

What was done: drives reimbursement. Showing 8 of 8.

Code	Service	Reimb.
90834	Psychotherapy, 45 min Most common therapy code	$95–140
90837	Psychotherapy, 60 min Full-hour session	$130–180
96127	Brief assessment PHQ-9, GAD-7, etc.; up to 4 units	$4–6 per unit
90791	Diagnostic evaluation Initial intake (no medical svc)	$140–200
90792	Diagnostic evaluation w/ medical Initial intake (with prescriber)	$160–220
99213	E/M established, low complexity Med management visit	$80–120
99214	E/M established, moderate complexity Most common med management	$120–170
90847	Family therapy with patient 50-min family/couple session	$120–160

All CPT codes →

ICD-10 codes (diagnoses)

Why it was done: establishes medical necessity. Showing 10 of 10.

Code	Diagnosis	Scale
F32.1	MDD, Single Episode, Moderate	PHQ-9
F33.1	MDD, Recurrent, Moderate	PHQ-9
F41.1	Generalized Anxiety Disorder	GAD-7
F43.10	PTSD, Unspecified	PCL-5
F31.1	Bipolar I, Manic	MDQ
F90.0	ADHD, Predominantly Inattentive	ASRS
F84.0	Autism Spectrum Disorder	RAADS-R
F10.20	Alcohol Use Disorder, Uncomplicated	AUDIT
F60.3	Borderline Personality Disorder	MSI-BPD
F50.81	Binge Eating Disorder	BES

All ICD-10 codes →

Common pairings

A typical 45-minute session billing for measurement-based care looks like one psychotherapy code + one or more 96127 units, paired with the ICD-10 diagnosis the scale informs.

ICD-10	Diagnosis	CPT bundle	Scale
F33.1	MDD, Recurrent, Moderate	90834 + 96127×1	PHQ-9
F41.1	Generalized Anxiety	90834 + 96127×1	GAD-7
F43.10	PTSD, Unspecified	90834 + 96127×1	PCL-5
F10.20	Alcohol Use Disorder	90834 + 96127×1	AUDIT
F90.0	ADHD, Inattentive	99214 + 96127×1	ASRS
F33.1 + F41.1	Depression + GAD comorbid	90834 + 96127×2	PHQ-9 + GAD-7

Other markets, international billing references

CPT is U.S.-only. Other countries use their own service-coding systems. Authoritative references for HiBoop's core markets:

🇨🇦 Canada

ICD-10-CA + provincial billing

Each province maintains its own service code set. No CPT equivalent.

🇦🇺 Australia

ICD-10-AM + MBS item numbers

Medicare Benefits Schedule (MBS) item numbers replace CPT entirely.

🇬🇧 United Kingdom

WHO ICD-10 + NHS structure

NHS billing operates on national tariffs and Mental Health Currencies (clusters), not service codes.

🇳🇿 New Zealand

ICD-10-AM + Te Whatu Ora

New Zealand uses Australia's ICD-10-AM modification; Te Whatu Ora (Health New Zealand) administers public mental health funding.

🇮🇪 Ireland

WHO ICD-10 + HSE

HSE administers public mental health services; private practice operates independently.

🇸🇬 Singapore

WHO ICD-10 + MOH framework

Ministry of Health administers public mental health; MediShield/MediSave determine private reimbursement.

Reach out via contact if you'd like the page expanded with country-specific code references for your market.

DSM-5-TR ↔ ICD-11 ↔ CPT, how they fit together

Three systems work together on every behavioral health claim:

DSM-5-TR – the American Psychiatric Association's clinical criteria for each disorder. Defines symptoms, duration, exclusions.
ICD-10-CM – the standardized codes used in U.S. claims and reporting. Each disorder defined in DSM-5-TR cross-references to one or more ICD-10-CM codes.
CPT – the AMA's billing codes that describe the service performed.

Same disorders, three views: DSM-5-TR for clinical criteria, ICD-11 / ICD-10-CM for diagnosis coding, CPT for service billing.

Frequently asked questions

What billing codes are used in mental health and therapy?

Mental and behavioral health claims use two coding systems together: ICD-10-CM diagnosis codes (F32.x, F33.x, F41.1, etc.) establish medical necessity, and CPT service codes (90834, 96127, 90791) describe what was performed. Both are required on most claims.

What is the most common therapy billing code?

CPT 90834 (Psychotherapy, 45 minutes) is the most commonly billed therapy code. Therapists without prescriptive authority typically bill psychotherapy codes; prescribers often bill E/M codes (99213/99214) instead.

What CPT code is used to bill PHQ-9 or GAD-7 administration?

CPT 96127. Bills validated brief screeners including PHQ-9, GAD-7, PCL-5, AUDIT. Up to 4 units per visit at typically $4–6 per unit.

What ICD-10 codes are most common in therapy billing?

F33.1 (Recurrent MDD, Moderate), F41.1 (Generalized Anxiety), F43.10 (PTSD), F90.0 (ADHD), F31.81 (Bipolar II), F50.81 (Binge Eating), F60.3 (BPD) are among the most frequently used.

Do I need both an ICD-10 and a CPT code on every claim?

Yes, on most behavioral health claims. CPT drives reimbursement; ICD-10 establishes medical necessity. A claim with only one is typically denied.

How much does mental health billing reimburse?

Approximate national medians: 90834 ~$95–140, 90837 ~$130–180, 90791 ~$140–200, 96127 ~$4–6/unit (up to 4 units), 99214 ~$120–170. Verify with your specific payer fee schedules.

Sources & Citations

1.
American Medical Association. Current Procedural Terminology (CPT) 2026.
2.
American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR).
3.
Centers for Disease Control and Prevention. ICD-10-CM Official Coding Guidelines.
4.
Centers for Medicare & Medicaid Services. Physician Fee Schedule.