CPT 90833 is the add-on code for 30 minutes of individual psychotherapy provided alongside an Evaluation and Management visit, the billing mechanism for psychiatrists providing combined medication management and therapy.

Quick Reference

Code Type: Add-On CPT Code
Psychotherapy Duration: 30 min (At least 16 min required)
2026 Medicare Rate: ~$68–$90 (In addition to E/M code)
Requirement: Must Bill with E/M Code

What is CPT Code 90833?

CPT 90833, Psychotherapy, 30 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure) is an add-on CPT code that allows clinicians, primarily psychiatrists, to bill for 30 minutes of individual psychotherapy provided on the same date as a separately documented Evaluation and Management (E/M) service.

Because 90833 is an add-on code, it cannot be billed alone. It must always be reported alongside a primary E/M code (typically 99212–99215 for established patients, or 99202–99205 for new patients). The E/M component covers the medical decision-making and medication management; 90833 covers the distinct psychotherapeutic work performed in the same visit.

This is the most common billing structure for psychiatrists who provide "med-plus-therapy" sessions. When both services are provided, the E/M component must be separately documented from the psychotherapy, and the psychotherapy must meet the minimum 16-minute threshold to qualify as a 30-minute add-on.

Minimum Time Requirement: Per AMA guidelines, at least 16 minutes of face-to-face psychotherapy time is required to bill CPT 90833. The time spent on the E/M component is not counted toward the 16-minute psychotherapy threshold. Both components must be separately documented.

When to Bill CPT 90833

Use 90833 When:

A psychiatrist or prescribing clinician provides medication management (E/M) AND at least 16 minutes of individual psychotherapy in the same visit.
Both services are separately documented in the medical record.
The psychotherapy is performed with the same patient on the same date as the E/M service.
The patient has given consent for the combined service.

Do NOT Use 90833 When:

You are a therapist without prescribing authority, use standalone codes (90832, 90834, 90837) instead.
The psychotherapy lasted fewer than 16 minutes.
No E/M service was provided on the same date.
You want to bill 90833 without also billing a primary E/M code, it is an add-on only.
The session was group therapy, use group therapy codes (90853).

CPT 90833 Add-On Code Pairings

Primary Code	Description	Add 90833 For	Notes
99213 + 90833	Est. patient E/M, 20–29 min + psychotherapy	Brief med check with therapeutic discussion	Most common combo in outpatient psychiatry
99214 + 90833	Est. patient E/M, 30–39 min + psychotherapy	Complex med management + therapy	Higher-complexity presentations
99215 + 90833	Est. patient E/M, 40–54 min + psychotherapy	Highly complex med management + therapy	Less common; high documentation burden
99204 + 90833	New patient E/M, moderate complexity + therapy	New psychiatric intake with therapeutic work	Appropriate for initial psychiatric evaluation + therapy

Modifier 25 is NOT required on the E/M code when billing with 90833 (psychotherapy add-ons are exempt from modifier 25 requirements). However, separate documentation for each service is still required.

CPT 90833 vs Other Psychotherapy Codes

Code	Description	Add-On?	Time	Common Use
90833	Psychotherapy add-on, 30 min (with E/M)	Yes	≥16 min	Psychiatrist: med-plus-therapy visit
90836	Psychotherapy add-on, 45 min (with E/M)	Yes	≥31 min	Longer therapy component with E/M
90838	Psychotherapy add-on, 60 min (with E/M)	Yes	≥46 min	Extended therapy with E/M; rarely used
90832	Individual psychotherapy, 30 min	No	16–37 min	Therapy without same-day E/M (therapists)
90834	Individual psychotherapy, 45 min	No	38–52 min	Standard therapy session (therapists)
90837	Individual psychotherapy, 60 min	No	≥53 min	Longer therapy session (therapists)

Documentation Requirements for CPT 90833

E/M Note Must Include:

Chief complaint and history of present illness
Mental status examination
Medication review and changes
Medical decision-making or time documentation
Plan for medication management

Psychotherapy Note Must Include:

Start and stop time (or total face-to-face minutes)
Psychotherapy techniques used (CBT, DBT, psychodynamic, etc.)
Content of therapeutic interventions
Patient response to therapy
Therapeutic goals and progress

CPT 90833 FAQ

What is CPT code 90833?

CPT 90833 is an add-on code for 30 minutes of individual psychotherapy provided on the same date as an Evaluation and Management (E/M) service. It is primarily used by psychiatrists who provide both medication management and psychotherapy in a single visit. At least 16 minutes of face-to-face psychotherapy is required, and both the E/M and psychotherapy components must be separately documented.

Can a therapist (LCSW, LPC) bill CPT 90833?

Generally, no. CPT 90833 is an add-on to an E/M service, and E/M services require prescribing authority or medical decision-making capacity, typically a physician, NP, or PA. Therapists (LCSWs, LPCs, psychologists without prescribing privileges) provide psychotherapy only and bill standalone codes: 90832 (30 min), 90834 (45 min), or 90837 (60 min). Verify scope of practice with your state licensing board and payer policies.

What is the difference between CPT 90833 and 90832?

CPT 90832 is a standalone 30-minute psychotherapy code used when no E/M service is provided on the same day (typically by therapists). CPT 90833 is an add-on code requiring a same-day E/M service, used by psychiatrists providing combined medication management and therapy. The documentation requirements also differ: 90833 requires separate E/M and psychotherapy notes; 90832 requires a single therapy note.

What E/M codes can 90833 be billed with?

CPT 90833 can be billed with any appropriate E/M code, most commonly 99213 or 99214 for established patients in outpatient psychiatric settings. New patient visits may use 99203–99205. The E/M level must be supported by documentation of medical complexity, decision-making, and/or time. Do not bill E/M codes below the minimum documentation threshold simply to add 90833.

Do I need modifier 25 with CPT 90833?

No. Unlike some other CPT pairings, modifier 25 is NOT required on the E/M code when billing 90833 alongside an E/M service. The psychotherapy add-on codes (90833, 90836, 90838) are exempt from the modifier 25 requirement. However, both the E/M and psychotherapy components must still be separately documented in the medical record.

What is the Medicare reimbursement rate for CPT 90833?

The 2026 Medicare national average for CPT 90833 is approximately $68–$90 (varies by geographic locality and Medicare Administrative Contractor). This is in addition to the payment for the primary E/M code. Most commercial payers also reimburse 90833 when billed with a supporting E/M service, but rates and policies vary, always verify with your specific payer.

CPT Code 90833: Psychotherapy Add-On with E/M Service