Substance Abuse Therapy Billing: CPT Codes and Coverage
CPT codes for substance abuse therapy including 90837, 90853 group sessions, ICD-10 F10–F19 code breakdown, and how mental health parity law applies.
2026-03-25 · 6 min read · By Dr. Sarah Mitchell, Clinical Content Reviewer
Substance abuse and addiction therapy billing involves both standard psychotherapy codes and substance-use-specific codes, paired with a distinct ICD-10 chapter. Thanks to mental health parity law, coverage has improved significantly — but navigating the codes correctly still requires careful attention.
CPT Codes for Substance Abuse Therapy
Individual therapy for substance use disorders uses the same time-based psychotherapy codes as any other mental health condition:
- 90837 — 60-minute individual psychotherapy. The most common code for full individual substance abuse counseling sessions.
- 90834 — 45-minute individual psychotherapy.
- 90832 — 30-minute individual psychotherapy. Common for brief check-ins in outpatient substance abuse programs.
- 90853 — Group psychotherapy. Very widely used in substance abuse treatment — 12-step facilitation groups, relapse prevention groups, and process groups all bill under 90853 per participant.
- 90791 — Psychiatric diagnostic evaluation. Used for the initial substance use assessment, often including a formal addiction severity evaluation.
Substance-Use-Specific Codes
Beyond the standard psychotherapy codes, substance abuse treatment settings also use:
- H0001 — Alcohol and/or drug assessment. A HCPCS Level II code used primarily by addiction-specific programs and some Medicaid plans. Not used by most commercial insurers, which prefer 90791 for the same service.
- H0004 — Behavioral health counseling and therapy, per 15 minutes. A HCPCS code used by some Medicaid programs and managed behavioral health organizations (MBHOs) for substance abuse counseling. Check payer requirements before using H-codes.
- 99408 — Alcohol and/or substance (other than tobacco) abuse structured screening and brief intervention (SBIRT), 15–30 minutes. Used in primary care and integrated settings, not typically in standalone mental health practice.
ICD-10 Codes: The F10–F19 Chapter
Substance-related disorder diagnoses occupy ICD-10 chapter F10–F19, organized by substance:
- F10.x — Alcohol-related disorders (F10.10 = alcohol use disorder, mild; F10.20 = moderate/severe)
- F11.x — Opioid-related disorders
- F12.x — Cannabis-related disorders
- F13.x — Sedative/hypnotic/anxiolytic-related disorders
- F14.x — Cocaine-related disorders
- F15.x — Other stimulant-related disorders (including methamphetamine)
- F16.x — Hallucinogen-related disorders
- F17.x — Nicotine dependence (not typically covered under mental health benefits but sometimes covered under preventive care)
- F18.x — Inhalant-related disorders
- F19.x — Multiple substance use / other psychoactive substance disorders
The fourth and fifth digits specify the pattern (use, dependence, withdrawal) and any complications. For example, F10.239 = alcohol dependence with withdrawal, unspecified. Use the most specific code that reflects the documented clinical picture. Co-occurring diagnoses (e.g., F32.1 major depressive disorder with F10.20 alcohol use disorder, moderate) should both be listed when present.
Mental Health Parity and Substance Abuse Coverage
The Mental Health Parity and Addiction Equity Act (MHPAEA) requires most insurers to cover substance use disorder treatment at parity with medical and surgical benefits. In practice this means:
- Insurers cannot impose more restrictive prior authorization requirements on substance abuse treatment than on comparable medical services.
- Session limits for outpatient SUD counseling must match those for equivalent medical outpatient visits.
- If a parity violation is suspected, you can file a complaint with your state insurance commissioner or the U.S. Department of Labor (for employer plans).
Out-of-Network Substance Abuse Therapy
Clients seeking OON substance abuse treatment can submit superbills to their insurer for reimbursement, just like any other mental health service. Superbilled generates compliant superbills listing the correct CPT and ICD-10 codes, making it easy for clients to pursue reimbursement from their out-of-network benefits.