Toolkit · Practice & profession
CPT quick reference for outpatient psychiatry.
An educational overview of the CPT codes most commonly used in outpatient psychiatric practice, E/M levels, psychiatric evaluations, psychotherapy, and common add-ons.
Written by Shariq Refai, MD, MBA · Last reviewed July 10, 2026
Before you use this reference, please read.
Not billing, coding, or legal advice. This page is a plain-language educational overview of common outpatient psychiatry CPT codes. It isn't a substitute for the authoritative AMA Current Procedural Terminology manual, current CMS guidance, payer policy, or a certified professional coder. Coding rules change every year, vary by payer and state, and depend on documentation you actually produced, not on what a summary page says.
CPT is copyright of the American Medical Association. Current Procedural Terminology (CPT®) codes, descriptors, and guidelines are copyright © American Medical Association. All rights reserved. Full CPT descriptors aren't reproduced here. What follows are paraphrased educational summaries. For authoritative descriptors, times, and rules, consult the current AMA CPT resources or the AMA CPT Professional Edition.
Before you bill anything based on this page: confirm the current-year definitions in the AMA CPT manual, review your payer's policies, verify state licensure and scope-of-practice rules, and have your workflow reviewed by a compliance professional. You're responsible for what you bill.
Quick answer
Outpatient psychiatry billing usually pulls from three families of CPT codes: E/M codes (99202 to 99205 for new patients, 99213 to 99215 for established) that reflect medical decision-making or time; psychiatric diagnostic evaluation codes (90791 for non-medical clinicians, 90792 for medical clinicians providing an evaluation with medical services); and psychotherapy codes (90832 / 90834 / 90837 as stand-alones, or 90833 / 90836 / 90838 as add-ons to an E/M code). Add-ons like 90785 (interactive complexity) and G2211 (complexity of continuing longitudinal care) can attach to appropriate visits. Telehealth versions use modifier 95 and appropriate place-of-service.
Level of service E/M codes (2021 rules, still in effect).
Since January 2021, CMS and AMA moved to a decision-making-or-time model for office E/M. You can pick the code based on either medical decision-making (MDM) or the total practitioner time on the date of encounter. Documentation must support the chosen basis. Whether MDM or time is more advantageous varies by encounter.
| Code | Patient type | MDM level | Total time (date of encounter) | Typical use in psychiatry |
|---|---|---|---|---|
| 99213 | Established | Low | 20 to 29 minutes | Stable follow-up, no medication change, straightforward review. |
| 99214 | Established | Moderate | 30 to 39 minutes | Symptom change, medication adjustment, moderate complexity, the most common outpatient psychiatry follow-up level. |
| 99215 | Established | High | 40 to 54 minutes | Significant symptom worsening, safety concern, multiple problems addressed, high complexity decision-making. Payer audit scrutiny is high for this code, documentation of MDM elements or time must clearly support the level. |
New-patient outpatient E/M codes.
| Code | Patient type | MDM level | Total time (date of encounter) | Typical use |
|---|---|---|---|---|
| 99202 | New | Straightforward | 15 to 29 minutes | Rarely appropriate for a psychiatric new-patient intake, MDM is typically higher. |
| 99203 | New | Low | 30 to 44 minutes | Occasionally appropriate for a brief, uncomplicated new-patient evaluation. |
| 99204 | New | Moderate | 45 to 59 minutes | The common new-patient psychiatry intake when 90792 isn't billed. |
| 99205 | New | High | 60 to 74 minutes | Complex new-patient intake, multiple diagnoses, safety issues, medication complexity. Payer audit risk is real; document thoroughly. |
Psychiatric diagnostic evaluation.
| Code | Description (paraphrased) | Who typically uses it |
|---|---|---|
| 90791 | Psychiatric diagnostic evaluation, no medical services element. | Non-prescribing clinicians: licensed clinical social workers, licensed professional counselors, marriage and family therapists, some psychologists (per payer). |
| 90792 | Psychiatric diagnostic evaluation with medical services (history, mental status exam, medical decision-making, and prescribing considerations). | Physicians, psychiatric nurse practitioners, and physician assistants who can prescribe. Common alternative to a level-4 or level-5 new-patient E/M for a first psychiatric visit. |
Psychotherapy codes.
Psychotherapy codes come in stand-alone and add-on versions. Stand-alone codes are used when the visit's psychotherapy without a separately identifiable E/M service. Add-on codes attach to an E/M visit when psychotherapy is provided in addition to (not instead of) the medical service. Documentation must clearly separate the E/M work from the psychotherapy work when billing both.
| Code | Type | Typical time | Notes |
|---|---|---|---|
| 90832 | Stand-alone | 16 to 37 min | Short psychotherapy session. |
| 90834 | Stand-alone | 38 to 52 min | The most commonly billed stand-alone psychotherapy code. |
| 90837 | Stand-alone | 53+ min | Extended psychotherapy session. Payer audit scrutiny is higher for this code. |
| 90833 | Add-on | 16 to 37 min | Attach to an E/M code (e.g., 99214 + 90833) when psychotherapy is provided in addition to the medical visit. |
| 90836 | Add-on | 38 to 52 min | Add-on to E/M. |
| 90838 | Add-on | 53+ min | Add-on to E/M. |
Modifiers you'll need.
Modifiers are two-character extensions appended to CPT codes that change their meaning without changing the code. Three come up constantly in outpatient psychiatry.
- Modifier 25, significant, separately identifiable evaluation and management service by the same physician or qualified healthcare professional on the same day as another procedure or service. Frequently appended to an E/M code when billed on the same day as a psychotherapy stand-alone (e.g., 99213-25 with 90837), a psychological test, or another procedure. Don't attach modifier 25 to an E/M billed with a psychotherapy add-on (90833 / 90836 / 90838), the add-on already presumes a separate E/M service.
- Modifier 59, distinct procedural service. Less common in outpatient psychiatry but relevant when two same-day services would otherwise be bundled. Payer definitions of when 59 is required have evolved (Medicare's XE / XP / XS / XU subsets exist for some scenarios).
- Modifier 95, synchronous telemedicine service rendered via real-time interactive audio and video. See the telehealth section below.
Common add-on and related codes.
The codes below include both CPT and Medicare HCPCS Level II codes. HCPCS codes (G-codes) are administered by CMS and aren't part of AMA CPT; they're shown here because they're commonly billed alongside CPT codes in the same claims and are used for Medicare (and, increasingly, some commercial payers).
| Code | Family | Type | What it captures |
|---|---|---|---|
| 90785 | CPT | Add-on | Interactive complexity, communication barriers, third-party involvement, mandated reporting, sentinel event disclosure. Appends to an eligible E/M, diagnostic eval, or psychotherapy code. |
| G2211 | HCPCS (Medicare) | Add-on | Complexity of longitudinal, continuous care of a single serious or complex condition. Payable by Medicare beginning January 2024. Can't generally be reported on the same visit as an E/M with modifier 25, check current CMS guidance. Commercial payer coverage varies widely. |
| 99417 | CPT | Add-on | Prolonged outpatient E/M services beyond the maximum time of 99205 or 99215, in 15-minute increments. Used with commercial and some non-Medicare payers. |
| G2212 | HCPCS (Medicare) | Add-on | Medicare's analogue to 99417 for prolonged outpatient E/M, different time-threshold rules. Use G2212 (not 99417) for Medicare claims. |
| 99484 | CPT | Stand-alone | General behavioral health integration (BHI), care manager time coordinating behavioral health care, per calendar month. More often used in integrated primary care than solo outpatient psychiatry. |
| 99492 / 99493 / 99494 | CPT | Stand-alone | Collaborative care model (CoCM) codes, initial month (99492), subsequent months (99493), and additional 30-minute increments (99494). More often used in integrated care than solo outpatient psychiatry. |
Telehealth.
Telepsychiatry has its own set of rules, and they're still shifting. As of the last review date on this page:
- Modifier 95 is generally appended to synchronous audio-video telehealth encounters.
- Place of service (POS) codes for telehealth are: POS 10 (patient in home) and POS 02 (patient in a non-home telehealth originating site). Payer requirements vary; some still accept the pre-2022 approach (POS matching in-person + modifier).
- Audio-only visits use different codes and modifiers depending on payer. CMS has separate audio-only mental-health provisions that have been extended and modified during and after the COVID-19 public health emergency.
- Interstate telehealth requires appropriate licensure in the patient's state. Interstate compacts (IMLC for physicians, PsyPACT for psychologists, Counseling Compact) can help.
Because telehealth rules have been in flux since 2020 and continue to evolve, verify against current CMS Medicare Telehealth Services lists and each commercial payer's current policy before billing.
Documentation basics that support these codes.
Whatever code you bill, documentation must reflect the work you did:
- If billing by MDM, document the problems addressed, the data reviewed and analyzed, and the risk of complications from possible management options.
- If billing by time, document the total time on the date of encounter, including pre-visit review, the visit itself, and same-day post-visit documentation and orders. Time spent by other clinical staff doesn't count for physician time-based E/M.
- When billing an E/M plus psychotherapy add-on, the E/M component must be separately identifiable (a distinct medical service), and psychotherapy time is documented separately and doesn't count toward E/M time.
- When billing psychotherapy stand-alone (90832 / 90834 / 90837), document the type of therapy, targets, patient response, and time spent face-to-face.
Keeping this current.
CPT is updated every January by the American Medical Association. HCPCS Level II codes and CMS rules can change on quarterly cycles. This reference is written as of the last review date shown at the top. Before you bill anything based on this page, verify the current-year rules by consulting:
- The current AMA CPT Professional Edition (the authoritative source for CPT).
- The current CMS Physician Fee Schedule and Medicare Learning Network (MLN) publications for Medicare rules.
- Each commercial payer's current medical policy for their specific coverage rules.
If you find something on this page that's out of date or inaccurate, please let's know, we take corrections seriously and post them at the corrections page.
What this reference isn't.
This page is educational overview. It isn't the AMA CPT manual, not CMS guidance, not a payer contract, and not a legal opinion on billing compliance. It can't substitute for coding education, an experienced coder's review of your specific documentation, or the current-year AMA CPT Professional Edition.
Building or refining a psychiatric practice? shrinkiatry is the network's site for the profession of psychiatry, practice management, credentialing, telehealth setup, and the operational side of the work.
Sources and authoritative references.
- American Medical Association. CPT®, Current Procedural Terminology. Full descriptors and guidelines. The AMA CPT Professional Edition is the authoritative source.
- Centers for Medicare & Medicaid Services. Medicare Telehealth Services, current list and rules.
- American Psychiatric Association. Coding, reimbursement, Medicare, and Medicaid (member resources).
- CMS. Physician Fee Schedule and code lookup.
Related resources.
Keep going in the network
shrinkiatry is where the practice side of psychiatry lives. These go further than this card.
- The longer psychiatry coding reference, with notes on common mistakes. shrinkiatry
- Collaborative care billing codes, explained. shrinkiatry
- A prior authorization checklist you can actually use. shrinkiatry
- Cash pay versus insurance, from the practice side. shrinkiatry
- What a psychiatrist appointment costs, from the patient side. shrinkMD
How to cite this page
APA-style suggested citation:
Refai S. CPT quick reference for outpatient psychiatry. The Shrink Network Toolkit Library. Published July 10, 2026. Accessed [date]. https://shrinknetwork.com/toolkit/cpt-quick-reference/
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