CPT 90833Mental Health

Psytx w pt w e/m 30 min

CPT code 90833 is used when a healthcare provider performs 30 minutes of psychotherapy (talk therapy) during the same visit as a medical evaluation and management service. This is an add-on code that must be billed with a separate E/M code.

Showing rates for

National Average

Base Medicare rate

$72.78

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

1.64

PE RVU (NF)

0.55

MP RVU

0.06

Total RVU

2.25

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Always bill 90833 as an add-on code with a qualifying E/M code (99202-99215) to document distinct services
Impact: Prevents automatic denial; 90833 cannot be billed alone and will reject without primary E/M code
Document the 30-minute psychotherapy time separately from E/M service time; use time-stamped notes showing start/stop times
Impact: Protects against audit recoupment of $72.78 per claim and supports medical necessity for dual billing
Ensure the psychotherapy and medical components address distinctly different issues with separate documentation
Impact: Critical for audit defense; overlapping documentation is the #1 reason for denials, risking 100% of add-on payment
Bill non-facility rate ($72.78) for office settings and facility rate ($64.37) for hospital outpatient departments
Impact: Correct place of service coding prevents $8.41 overpayment recoupment or underpayment
For commercial payers, verify if credentialing allows non-physician mental health providers to bill 90833 independently
Impact: Some payers restrict this code to physicians only, requiring incident-to billing that may affect reimbursement by 15-20%
When billing with medication management E/M codes, clearly document therapeutic psychotherapy techniques beyond medication counseling
Impact: Vague documentation like 'medication discussed' will trigger denials; specific techniques protect $72.78 payment

Common denials

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Frequently asked questions

What is CPT code 90833 used for?

CPT 90833 is an add-on code for 30 minutes of psychotherapy performed during the same visit as a medical evaluation and management (E/M) service. It allows providers to bill separately for therapy when addressing mental health concerns alongside medical issues in a single encounter.

How much does Medicare pay for CPT 90833 in 2025?

Medicare pays $72.78 for CPT 90833 in non-facility settings and $64.37 in facility settings for 2025, based on the national average. The code has 2.25 total RVUs (1.64 work RVU, varying practice expense RVUs, and 0.06 malpractice RVU).

Can 90833 be billed alone?

No, CPT 90833 is an add-on code that must be billed with a primary E/M code (typically 99202-99215 for office visits). Billing 90833 without a qualifying E/M code will result in automatic claim denial.

What is the difference between 90833 and 90832?

CPT 90832 is a standalone code for 30 minutes of psychotherapy only, while 90833 is an add-on code for 30 minutes of psychotherapy performed with a separate E/M service during the same visit. Use 90832 for therapy-only visits and 90833 when combining therapy with medical evaluation.

How do I document CPT 90833 to avoid denials?

Document start and stop times for the 30-minute psychotherapy, specific therapeutic techniques used, patient response, and a separate E/M section addressing distinct medical issues. Ensure the psychotherapy and medical components address different diagnoses or aspects of care with clear documentation of medical necessity for both.

Can a nurse practitioner bill CPT 90833?

Yes, nurse practitioners and physician assistants can bill 90833 if they are credentialed to provide both E/M and psychotherapy services and meet state scope-of-practice requirements. However, some commercial payers may have restrictions, so verify individual payer policies.

What E/M codes can be billed with 90833?

CPT 90833 is typically billed with office visit E/M codes 99202-99215, but can also be used with other appropriate E/M codes such as hospital observation (99217-99220, 99224-99226), initial hospital care (99221-99223), or subsequent hospital care (99231-99233) when psychotherapy is provided during those encounters.