Behavioral Health ICD-10 Codes & CPT Codes

Behavioral health coding covers a broad spectrum of mental, emotional, and substance use disorder diagnoses. This reference covers the most-billed ICD-10-CM and CPT codes for licensed behavioral health counselors, social workers, therapists, and community behavioral health organizations across the United States.

FY 2026 ICD-10-CM (CMS) · All codes verified billable · Last verified: June 2026

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Top ICD-10 Codes for Behavioral Health

ICD-10 Code Description Billable
F32.9 Major depressive disorder, single episode, unspecified ✓
F41.1 Generalized anxiety disorder ✓
F43.10 Post-traumatic stress disorder, unspecified ✓
F10.10 Alcohol abuse, uncomplicated ✓
F10.20 Alcohol dependence, uncomplicated ✓
F11.10 Opioid abuse, uncomplicated ✓
F11.20 Opioid dependence, uncomplicated ✓
F84.0 Autistic disorder ✓
F90.2 ADHD, combined type ✓
F60.3 Borderline personality disorder ✓
F50.01 Anorexia nervosa, restricting type ✓
F31.9 Bipolar disorder, unspecified ✓
Z71.89 Other specified counseling ✓
F06.30 Mood disorder due to known physiological condition, unspecified ✓
F19.10 Other psychoactive substance abuse, uncomplicated ✓
F32.1 Major depressive disorder, single episode, moderate ✓
F32.2 Major depressive disorder, single episode, severe without psychotic features ✓
F33.1 Major depressive disorder, recurrent, moderate ✓
F33.9 Major depressive disorder, recurrent, unspecified ✓
F40.10 Social phobia, unspecified ✓
F41.0 Panic disorder without agoraphobia ✓
F41.9 Anxiety disorder, unspecified ✓
F43.12 Post-traumatic stress disorder, chronic ✓
F43.21 Adjustment disorder with depressed mood ✓
F43.23 Adjustment disorder with mixed anxiety and depressed mood ✓
F20.9 Schizophrenia, unspecified ✓
F25.9 Schizoaffective disorder, unspecified ✓
F31.30 Bipolar disorder, current episode depressed, mild or moderate severity, unspecified ✓
F60.01 Paranoid personality disorder ✓
F60.4 Histrionic personality disorder ✓
F50.2 Bulimia nervosa ✓
F50.82 Avoidant/restrictive food intake disorder ✓
F90.0 ADHD, predominantly inattentive type ✓
F90.1 ADHD, predominantly hyperactive type ✓
F42.2 Mixed obsessional thoughts and acts (OCD) ✓
F45.1 Undifferentiated somatoform disorder ✓
F63.3 Trichotillomania ✓
F80.9 Developmental disorder of speech and language, unspecified ✓
Z13.30 Encounter for screening for mental health disorders, unspecified ✓
F34.1 Dysthymic disorder ✓

Source: CMS ICD-10-CM FY 2026

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Common CPT Codes for Behavioral Health Billing

CPT Code Description Medicare Rate* Common Modifiers
90791 Psychiatric diagnostic evaluation without medical services ~$165 -GT (telehealth), -95
90792 Psychiatric diagnostic evaluation with medical services ~$220 -GT, -25
90832 Psychotherapy, 30 minutes with patient ~$78 -GT, -95, -59
90834 Psychotherapy, 45 minutes with patient ~$107 -GT, -95
90837 Psychotherapy, 60 minutes with patient ~$150 -GT, -95, -59
90838 Psychotherapy add-on, 60 min with E/M ~$105 -Add-on to E/M
90845 Psychoanalysis ~$130 -GT
90847 Family psychotherapy with patient present, 50 minutes ~$120 -GT, -95
90849 Multiple-family group psychotherapy ~$82 -GT
90853 Group psychotherapy (non-family) ~$58 -GT, -95
90863 Pharmacologic management, with psychotherapy ~$34 -Add-on only
90875 Individual psychophysiological therapy (biofeedback), 30 min ~$96 -59
96127 Brief emotional/behavioral assessment with scoring ~$9 -25
99213 Office visit, established patient, low complexity (15-29 min) ~$95 -25, -59
99214 Office visit, established patient, moderate complexity (30-39 min) ~$137 -25, -59
H0004 Behavioral health counseling and therapy, per 15 min (HCPCS/Medicaid) N/A Medicaid only
H2019 Therapeutic behavioral services, per 15 min (HCPCS) N/A Medicaid, state-specific

*Approximate 2025 CMS national non-facility rate. Rates vary by geography, setting, and payer contract. Refer to the CMS Physician Fee Schedule for official rates.

Top Denial Reasons for Behavioral Health Claims

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Medical Necessity Not Sufficiently Documented

Payers deny behavioral health claims when the clinical note lacks measurable impairment, treatment goals, or a stated diagnosis tied to the service. Ensure each session note includes a DSM-5 diagnosis, functional impairment level, and therapeutic goals with progress indicators.

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Missing or Invalid Prior Authorization

Many commercial payers and Medicaid managed care plans require prior authorization for ongoing psychotherapy, intensive outpatient programs (IOP), and residential treatment. Always verify auth requirements at intake and re-verify when a patient changes plans mid-treatment.

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Wrong Time-Based Code for Documented Session Length

Billing 90837 (60-min) when the note documents less than 53 minutes of face-to-face time triggers medical necessity denials and audit flags. Document the exact start/stop time and total face-to-face minutes for every psychotherapy session to support the code billed.

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Substance Use Disorder Code Specificity Mismatch

Submitting an unspecified F10.10 or F19.10 code when the record clearly documents dependence (F1x.2x) or a specific stage leads to claim downcoding or denial. Always code to the highest level of specificity supported by the clinical documentation to avoid payer downcoding.

Behavioral Health Billing & Coding Tips

  • Bill 90837 (60-min therapy) rather than 90834 (45-min) whenever session length supports it — the reimbursement difference can be significant over a full panel.
  • HCPCS code H0004 (behavioral health counseling per 15 min) is used by Medicaid managed care plans in many states — verify your state’s fee schedule before billing.
  • Document the place of service carefully: POS 11 (office), POS 53 (community mental health center), and POS 49 (independent clinic) each have different Medicaid rate structures.
  • Substance use disorder codes (F10-F19) require specifying the substance type AND the stage: abuse (F1x.1x), dependence (F1x.2x), or use (F1x.9x) — do not default to the unspecified version.

Frequently Asked Questions

What is the difference between behavioral health and mental health billing?

The terms overlap significantly. Behavioral health is a broader term covering mental health plus substance use disorders, eating disorders, and health-behavior change. In billing, behavioral health providers often use the same CPT psychotherapy codes (90832-90837). HCPCS H-codes are specific to Medicaid behavioral health programs.

What CPT code is used for group therapy?

90853 covers group psychotherapy for non-family groups. 90849 covers multiple-family group psychotherapy. Both require a licensed clinician present for the full session. Each patient is billed individually using 90853.

Is H0004 covered by Medicare?

No. H0004 (behavioral health counseling per 15 min) is a HCPCS Level II code used by Medicaid programs. Medicare uses CPT codes (90832-90837) for behavioral health therapy. Verify H0004 coverage and rates with the specific state Medicaid program.

What ICD-10 code is used for substance use counseling?

Z71.89 (Other specified counseling) is used for substance use prevention counseling. For active substance use disorders, use the specific F10-F19 code with the appropriate stage suffix (abuse, dependence, or use). Z71.41 (Alcohol abuse counseling) is also available.

How does OmniMD support behavioral health practices?

OmniMD’s Behavioral Health EHR supports DSM-5 diagnosis coding, HIPAA-compliant telehealth for remote therapy sessions, e-prescribing for prescribing providers, and integrated billing for both CPT and HCPCS behavioral health codes.

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