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BehavioralAdd-on2026 Compliant

CPT 90833

2026 Billing Guide

Psychotherapy Add-on 30 min

Reimbursement

$81.50

Threshold

30m

2026 Status

Active

What is CPT Code 90833?

CPT 90833 is defined as: Psychotherapy, 30 minutes with patient and/or family member when performed with an evaluation and management (E/M) service. This is an add-on code that must be reported in addition to a primary E/M service code.

This code is primarily used for Behavioral services. It falls under the category of Psychotherapy & Behavioral Assessments and is valid for the 2026 calendar year according to the CMS Physician Fee Schedule.

2026 RVU Components

Relative Value Units (Non-Facility)

Standard Formula Applied

Work RVU

1.71

Physician Effort

PE (Non-Fac)

0.62

Practice Expense

Malpractice

0.11

Risk Factor

Total RVU

2.44

Note: [(Work RVU * Work GPCI) + (PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor

2026 CMS Policy Intelligence

efficiency shield

Exempt from the -2.5% efficiency adjustment applied to procedural codes.

integrated model incentive

Reimbursement structure favors the E/M + Add-on model to encourage integrated physical and mental health care.

time vs mdm

Strict CMS mandate for 2026: E/M level MUST be selected based on MDM, not total time, when billed with 90833.

stacking benefit

Allows 'stacking' with G2211 to capture value for complexity (G2211) and therapy (90833).

Administrative Framework

Global Period

000

Place of Service

11 (Office)10 (Telehealth Provided in Patient's Home)21 (Inpatient Hospital)22 (On Campus-Outpatient Hospital)

NCCI Exclusions

Do not bill with:908329083490837

Key Modifiers

25Significant, Separately Identifiable Evaluation and Management Service. Append to the primary E/M code (e.g., 99214-25) to prevent automatic bundling denials when billed with 90833.
95Synchronous Telemedicine Service.

Required Primary Codes

99202-9920599212-9921599304-9931099341-99350

Must be billed alongside a primary service.

Operational Requirements

minimum time

16 minutes (Range: 16-37 minutes)

staff type

Prescribing Psych providers (Psychiatrist, Psychiatric NP/PA)

frequency

Typically once per day per patient

add on codes

time rule

The time for 90833 must be separate and distinct from the time spent on the MDM portion of the primary E/M service.

Compliance Checklist

Distinct Start/Stop times for the psychotherapy portion
Separate headings/sections for Medical Management (E/M) and Psychotherapy in the progress note
The note must unequivocally prove both services were distinct and medically necessary
Modifier 25 on the E/M code is best practice for many payers in 2026

Audit Defense

No specific audit defense elements defined.

2026 Update

The 'Time vs MDM Trap': Using time to justify E/M prevents billing 90833 for that same time.

Common Clinical Scenarios

Medication management visit where patient presents with increased anxiety requiring CBT intervention
Longitudinal management of complex chronic mental illness
Integrated 'med-psych' visits in outpatient clinics

CMS Eligibility: Diagnosis requiring both medical management (E/M) and psychotherapy. Variable

Target Specialties & Utilization

PsychiatryPsychiatric NursingNeurology

Typical Clinical Indications (ICD-10)

F31.9 (Bipolar disorder, unspecified)F33.1 (Major depressive disorder, recurrent, moderate)F42.2 (Mixed obsessional thoughts and acts)

Billing Differentiation

VS 90832

90832 is standalone; 90833 is an add-on to an E/M code.

VS 90836

90836 is the 45-minute add-on (Range: 38-52 minutes); 90833 is the 30-minute version.

valuation_note

wRVU for 90833 is lower than 90832 because 'pre/post-service' work is covered by the primary E/M code.

Frequently Asked Questions

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CPT Code 90833 for Psychotherapy Add-on 30 min - 2026 Reimbursement & Rules