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Clinical Specialty Hub CY 2026 / FY 2027 Guidelines
Verified: 2026-09-29

Mental & Behavioral Health Coding Hub

Coding guidelines for psychiatric diagnostic evaluations, individual psychotherapy, crisis intervention, and collaborative psychiatric care.

Top Diagnoses: 6 Core Codes
Top Procedures: 7 Core Procedures
Auditing Focus: High Priority
Data Source: CMS & Clinical Society Guidelines
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Core Specialty Coding Directive

What are the critical billing rules for Mental & Behavioral Health Coding Hub? When psychotherapy is provided alongside an E/M visit, bill the primary E/M code (e.g. 99213 or 99214) with add-on psychotherapy code 90833 or 90836. Do not use modifier 25 on the add-on code.

Updated for current Medicare Part B coverage policies and NCCI quarterly edit tables.

Frequently Billed ICD-10-CM Diagnosis Codes

Click any diagnosis code to view complete CDC tabular guidelines, Excludes 1 exclusions, and billability status:

F32.9 →
Major depressive disorder, single episode, unspecified
F33.1 →
Major depressive disorder, recurrent, moderate
F41.1 →
Generalized anxiety disorder
F43.10 →
Post-traumatic stress disorder, unspecified
F90.9 →
Attention-deficit hyperactivity disorder, unspecified type
F10.20 →
Alcohol dependence, uncomplicated

Common CPT & HCPCS Procedure Codes

Code Description Reimbursement Bridge
90791 Specialty procedure or diagnostic service Standard PFS Code
90792 Specialty procedure or diagnostic service Standard PFS Code
90832 Specialty procedure or diagnostic service Standard PFS Code
90834 Specialty procedure or diagnostic service Standard PFS Code
90837 Specialty procedure or diagnostic service Standard PFS Code
90833 Specialty procedure or diagnostic service Standard PFS Code
90836 Specialty procedure or diagnostic service Standard PFS Code

Essential Billing Modifiers for Mental & Behavioral Health Coding Hub

Modifier 25 Guidelines → Modifier 95 Guidelines → Modifier GT Guidelines →
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High-Risk Documentation & Audit Traps

When psychotherapy is provided alongside an E/M visit, bill the primary E/M code (e.g. 99213 or 99214) with add-on psychotherapy code 90833 or 90836. Do not use modifier 25 on the add-on code.
Audit Defense Recommendation: Medical records must contain explicit physician-authored clinical notes demonstrating medical necessity. Review NCCI PTP edits prior to submission using our free NCCI Edit Checker.
AAPC CPC Exam Focus

Certification Exam Key Concepts

Tests psychotherapy time thresholds (e.g. 90834 requires 38-52 minutes of face-to-face time) and distinguishing 90791 (without medical services) vs 90792 (with medical services).

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