CPT Code 90833: Psychotherapy Add-On to E/M — Complete Guide
CPT 90833 is billed alongside E/M codes when a prescriber provides medication management plus 16+ minutes of psychotherapy. Learn who can bill it, documentation requirements, and typical reimbursement.
2026-03-28 · 5 min read · By The Superbilled Team
CPT code 90833 is a psychotherapy add-on code billed alongside an evaluation and management (E/M) code when a prescriber provides both medication management and at least 16 minutes of psychotherapy in the same session. It is never billed alone.
What Is CPT 90833?
90833 represents 16–37 minutes of individual psychotherapy provided on the same day as an E/M service. It is billed as an add-on to an E/M code from the 99202–99215 range. The prescriber must document both the medical evaluation component and a separate, identifiable psychotherapy component.
For longer psychotherapy components, use:
Who Can Bill CPT 90833?
90833 can only be billed by providers who can both order medications and provide psychotherapy. In practice, this means:
- Psychiatrists (MD or DO)
- Psychiatric nurse practitioners (NPs with prescribing privileges)
- Primary care physicians or other MDs with appropriate training (less common)
Licensed therapists (LCSWs, LPCs, LMFTs, psychologists) who do not prescribe cannot bill 90833. They bill standalone therapy codes (90832, 90834, 90837) without an E/M component.
Time Requirements
The psychotherapy component must be at least 16 minutes of face-to-face time, documented separately from the E/M component. The total session time includes both the E/M and psychotherapy portions. For 90833, the total session will typically run 25–45 minutes.
Documentation Requirements
Payers scrutinize add-on psychotherapy codes carefully. Your note must include:
- Start and stop times (or total face-to-face time) for the psychotherapy component
- A description of the psychotherapy provided (not just medication discussion)
- A separately identifiable medical decision-making component that justifies the E/M code
- The E/M code level documented appropriately (medical complexity, problem count, or time)
Typical Reimbursement
90833 is an add-on code, so reimbursement is in addition to the base E/M code payment. Commercial payer rates vary, but typical ranges:
- Medicare non-facility rate: approximately $43–$48 (add-on amount)
- Commercial insurance: $40–$65 added to the E/M base rate
The combined E/M + 90833 reimbursement is generally less than billing two separate standalone codes would theoretically yield — the add-on model reflects time sharing between the two service components.
Superbill Considerations
When generating a superbill that includes 90833, list both the base E/M code and the 90833 add-on on separate line items. Include the diagnosis code(s), date of service, and the total charge for each. Clients submitting to commercial insurance should be aware that some plans require prior authorization for psychiatric E/M visits. See prior authorization for mental health for more detail.