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
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.
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.
Streamline Your Behavioral Health Practice with OmniMD
Purpose-built EHR, billing, and practice management for Behavioral Health practices.
