CPT Codes for Therapists: The Complete Cheat Sheet (2026)

The entire billable universe of a therapy practice fits on an index card. About a dozen five-digit codes cover everything you will ever do in a clinical hour — every intake, every session, every couple, every group, every crisis. And yet nobody hands you the card. Not in graduate school, not at licensure, not when you open your practice. Most of us assemble it the expensive way: from denial letters, one code at a time.

This post is the card. Think of it as a chart of the harbor — not every rock in the ocean, just the water you actually sail: what each code means, the time rules that separate them, what Medicare pays as a reference point, and what your note has to show to keep the payment. Bookmark it; the rest of this article is commentary on one table.

How CPT codes actually work

Three principles run the whole system. First: one primary service code per session. A session is an intake, or individual therapy, or family therapy, or group — you pick the single code that describes what happened, and add-on codes (marked with a + in the CPT book) attach to it when they apply. Second: time rules are ranges, not labels. The "45-minute code" actually covers 38–52 minutes; the code is chosen by documented face-to-face time, not by what you call the appointment. Third — and this is the one that catches people — the code describes the service, not your intention. What you did in the room and what you call it on the claim are two different acts, and the note is the bridge between them. If the note doesn't support the code, the code didn't happen.

The codes themselves come from the AMA's Current Procedural Terminology, and the psychotherapy set has been stable for years — the codes below are the same ones you billed last year. What moves annually is the money: Medicare resets its fee schedule each January, and commercial payers reprice off their own contracts. So learn the codes once, and treat the rates as weather.

The master table

Rates are approximate 2026 Medicare national non-facility figures, before geographic adjustment — a floor and a reference point, not a promise. Commercial payers set their own rates, commonly somewhere between 1× and 2× Medicare.

(One line for the prescribers: 90833, 90836, and 90838 are psychotherapy add-ons billed alongside an E/M visit — psychiatrist and psychiatric-NP territory, not codes a therapist files.)

90791: the intake

Every treatment episode starts here. 90791 is the psychiatric diagnostic evaluation — the integrated biopsychosocial assessment: presenting problem, history, mental status, risk, diagnosis, and the beginnings of a treatment plan. It's untimed, and it pays more than any individual session code (≈$173 vs. ≈$167 for 90837 under 2026 Medicare) because payers are buying the workup, not the minutes. Its sibling 90792 is the same evaluation with medical services — history and physical elements, prescribing decisions — and belongs to psychiatrists and psychiatric NPs.

How often can you bill it? Typically once per episode of care, per clinician. Payer rules vary — many allow a new 90791 when a client returns after a genuine gap in treatment, when there's a distinctly new episode, or when the client transfers to a new clinician who must do their own evaluation. Some payers cap it at once per six or twelve months. When in doubt, check the plan; billing a second 90791 mid-treatment because a session "felt evaluative" is a common denial. Your first clinical hour with a new client is also the foundation of the chart — our intake process guide covers what belongs in it.

90832 / 90834 / 90837: the individual session family

Three codes, one dimension: documented face-to-face time. 90832 covers 16–37 minutes, 90834 covers 38–52, and 90837 covers 53 and up. The ranges come from CPT's midpoint rule — you bill the code whose stated time you've crossed the midpoint of — and they work like buoys marking the channel: a 50-minute hour is 90834 water, and 90837 doesn't start until minute 53. The practical consequences: your "therapy hour" of 45–50 minutes is 90834, a genuine hour is 90837 (and pays about $53 more under Medicare), and the time in your note — not the calendar slot — is what justifies either. Whether to run 53-minute sessions, and what payers do when every claim is a 90837, is its own topic; the full breakdown is in 90837 vs. 90834.

Don't dismiss 90832, either. It reads like a consolation prize, but it's the honest code for real clinical situations: a session cut short at minute 30, a check-in cadence with a stabilizing client, a young child whose attention runs out at 25 minutes. Sixteen minutes is the floor — below that, no individual psychotherapy code applies at all. And a session that runs 37 minutes is still 90832; minute 38 is where 90834 begins. Round to what happened, not to what you scheduled.

90847 / 90846: couples and family

90847 is family psychotherapy with the patient present — defined as a 50-minute service — and it is the workhorse of couples therapy. The wrinkle is the phrase "the patient." Insurance doesn't treat a couple as a client; it reimburses treatment of one identified patient, whose diagnosis carries the claim, with the partner present as a participant in that person's treatment. Deciding who the identified patient is, and writing notes about a relationship while the chart belongs to one person, is the central craft of couples documentation — we walk through it in the couples therapy notes guide.

90846 is the same service without the identified patient in the room — you meet with the partner, the parents, the family, in service of the client's treatment. It's the right code for a parent session in a child case or a family meeting the client can't attend. Two cautions: the session must clearly serve the identified client's treatment plan (your note should say how), and a minority of plans don't cover 90846 at all — verify before you build it into a treatment routine. Both codes require at least 26 minutes to bill.

90853: group

Group psychotherapy is billed per attending member — each member generates their own claim line under their own insurance, roughly $30 per member under 2026 Medicare, and each member gets their own note. It's untimed (a 90-minute group is still one unit), capped at 10 participants under Medicare guidance, and governed by one iron rule: you bill the room, not the roster — never a member who wasn't there. The complete rules are in the 90853 billing guide, and if you're still deciding whether to run a group at all, start with how to start a therapy group.

90839 / 90840: crisis

When a session becomes a crisis intervention — an urgent assessment of a client in high distress, with a life-threatening or complex presentation that demands immediate attention — the crisis codes replace the ordinary session code. 90839 covers the first 30–74 minutes; +90840 adds each additional 30 minutes beyond that. These pay meaningfully more than a routine session (≈$152 for the first hour), and the documentation bar is correspondingly higher: the note must show the crisis state, the assessment of imminent risk, what you did to stabilize (safety planning, mobilizing family or emergency resources), the disposition, and the exact time. You cannot bill 90839 alongside a regular psychotherapy code for the same session — the crisis code is the session. Use them when they're real; a hard session with strong feelings is not a crisis, and payers know the difference.

The add-ons most therapists leave on the table

+90785, interactive complexity, attaches to an intake, an individual session, or a group when specific communication barriers make the work materially harder. The classic therapy examples: play therapy with a young child who can't use conversational language; working through an interpreter or sign-language interpreter; a session where discordant caregivers — separated parents at war over the treatment — must be managed to deliver care to the child; or having to involve a third party like child welfare after a disclosure. It's small money (≈$15), but it's honest money for genuinely harder work, and your note simply has to name the barrier. It does not attach to 90846 (no patient present) or to the crisis codes.

96127, brief emotional/behavioral assessment, is the code for standardized screeners — a PHQ-9 or GAD-7 administered, scored, and documented with the score in the chart. It's billed per instrument, many commercial plans cover it (some allow several units per visit), and it turns a good clinical habit — tracking symptoms with real numbers instead of impressions — into a modestly reimbursed one. Reimbursement varies enough by plan that we won't print a number; verify with your payers. If you're not using screeners routinely yet, measurement-based care is one of the few practices that improves outcomes and revenue at once.

And one line on 90887 — interpretation or explanation of findings to family members. It exists, it's occasionally the right description of a session, and it's rarely covered. Verify before you count on it.

A word on telehealth

Every code in the table bills the same way over video — same code, same rate structure. What changes is the claim's context: place-of-service code 10 (client at home) or 02 (client elsewhere), plus modifier 95 for audio-video or 93 for audio-only, per your payer's rules. Getting the POS wrong is one of the most common telehealth denials, and the fix is boring and mechanical — we covered the whole thing in POS 02 vs. POS 10.

The code is only one box on the claim

Here's the thing the cheat sheet can't do alone: a claim is a small ship's manifest, and every line has to agree with every other line. The CPT code has to match the documented time. The place of service and modifiers have to match where and how the session happened. The diagnosis pointer has to connect the service to a covered diagnosis. The note has to support all of it. A correct code with the wrong POS is a denial; a 90837 with no time in the note is a takeback waiting for an audit. If the mechanics of claims are still fuzzy, start with billing explained; for what payers expect the note itself to contain, see insurance-ready documentation.

This is also exactly the kind of agreement software should enforce so you don't have to. In Practice Harbor, a session type carries its CPT code, place of service, and telehealth modifiers onto the claim automatically — schedule a 90834 telehealth session and the claim comes out a 90834 with POS 10 and modifier 95, every time — and screeners like the PHQ-9 are built in, administered and scored in the portal. The index card, in other words, is in the system, so your attention can stay in the room.