Neurofeedback and Biofeedback Billing: CPT Codes Explained

Neurofeedback and biofeedback are increasingly popular adjunctive treatments in mental health practice, but billing them correctly — and getting insurance to pay — requires understanding a distinct set of CPT codes and navigating highly variable coverage policies.

CPT Codes for Biofeedback and Neurofeedback

Biofeedback and neurofeedback are distinct in clinical practice but overlap in billing. The relevant codes are:

• 90901 — Biofeedback training, any modality. This is the primary biofeedback code and covers a full biofeedback session regardless of the specific modality (EMG, thermal, heart rate variability, skin conductance). It is not time-based — it is a per-session code.
• 90912 — Biofeedback training, perineal muscles, anorectal or urethral sphincter, initial 15 minutes. More specific to pelvic floor applications; rarely used in mental health contexts.
• 90913 — Biofeedback training, perineal muscles, each additional 15 minutes. Add-on to 90912; similarly niche for mental health settings.
• 97533 — Sensory integrative techniques, each 15 minutes. Sometimes used for neurofeedback with children, particularly in occupational therapy contexts. Requires careful documentation to justify.

Neurofeedback specifically — where EEG brainwave patterns are trained in real time — is most commonly billed under 90901 in mental health practice. There is no CPT code that says "neurofeedback" explicitly; the profession has historically used 90901 as the closest match.

Insurance Coverage: Highly Variable

Coverage for biofeedback and neurofeedback varies more than almost any other area of mental health billing. The situation by payer:

• Biofeedback (90901): Some commercial insurers cover biofeedback for specific, documented conditions — anxiety, chronic pain, hypertension, migraine. Documentation of medical necessity is essential. Many plans still classify it as investigational for psychiatric indications.
• Neurofeedback: Most major commercial insurers classify neurofeedback as experimental or investigational for mental health diagnoses including ADHD, PTSD, and anxiety, meaning they typically do not cover it. BCBS, Aetna, Cigna, and UHC all have coverage policies worth reviewing directly before billing.
• Medicaid: Coverage for biofeedback and neurofeedback under Medicaid is state-dependent. Most state Medicaid programs do not cover neurofeedback.

Diagnosis Codes That Support Medical Necessity

When biofeedback is covered by a plan, it is typically for specific diagnoses. Common pairings:

• F90.0–F90.9 — ADHD. Neurofeedback has a growing evidence base for ADHD; some plans cover it under specific medical necessity criteria.
• F41.1 — Generalized anxiety. HRV biofeedback has strong evidence for anxiety reduction.
• F43.10–F43.12 — PTSD. Neurofeedback is used adjunctively in trauma treatment programs.
• G43.x — Migraine. Biofeedback has Level A evidence for migraine prevention; this is one area where coverage is more consistent.

Combining Biofeedback With Psychotherapy

If you provide biofeedback and psychotherapy in the same session, you may bill both codes — but be aware that most payers apply a multiple-procedure reduction. Document clearly that the services were distinct: for example, a 20-minute HRV biofeedback training followed by 30 minutes of cognitive behavioral processing. Some payers will bundle the codes and pay only the higher-value service.

Out-of-Network and Self-Pay Neurofeedback

Given the inconsistent insurance coverage, many neurofeedback providers operate on a self-pay or out-of-network basis. Clients can submit superbills with CPT 90901 and the appropriate ICD-10 code to their insurer — even if denial is likely — to establish a record of services for potential future appeals. Superbilled generates compliant superbills for biofeedback and neurofeedback sessions with the correct code and diagnosis fields.