CPT® Code 90836 is used for a psychotherapy session lasting 45 minutes that is provided in conjunction with an evaluation and management (E/M) service. This code is commonly used by psychiatrists, psychiatric nurse practitioners, and other qualified mental health professionals who offer both medical management and psychotherapy during the same patient encounter.
When to use CPT® Code 90836
CPT code 90836 should be reported when a provider delivers 45 minutes of psychotherapy and also performs medical evaluation and management during the same session. This code must always be billed in conjunction with an E/M service (e.g., 99213 or 99214), not as a standalone code.
Providers should use 90836 only when the psychotherapy time component is documented as 45 minutes, and the session includes elements of medical evaluation such as medication management, review of labs, or medical decision-making.
Key components of a 90836 visit
- Duration: 45 minutes of psychotherapy
- Performed by: Physicians or other qualified healthcare professionals (e.g., NPs, PAs)
- Setting: Outpatient or office-based environments
- Services included: Psychotherapeutic intervention and E/M service
- Common conditions treated: Depression, anxiety disorders, bipolar disorder, PTSD, ADHD, and other psychiatric or behavioral health concerns
Documentation requirements
To correctly bill 90836, your clinical documentation must clearly show:
- That the psychotherapy portion lasted approximately 45 minutes
- That an E/M service was provided (with appropriate documentation of history, exam, and decision-making)
- That the time spent on psychotherapy is separate from the time spent on E/M
- The nature of the therapeutic intervention and the patient’s response
- Any medications reviewed, prescribed, or adjusted
Proper documentation is essential for compliance and reimbursement. Time-based notes, along with clear separation of services, will help support the dual billing of 90836 with an E/M code.
Reimbursement and payer considerations
Most commercial insurance plans and Medicare recognize 90836 when paired with an appropriate E/M code. However, reimbursement policies may vary by payer. It's important to confirm:
- Whether psychotherapy with E/M is a covered benefit
- Any limits on session duration or frequency
- Whether prior authorization is required
- Whether modifier 25 must be used with the E/M code to indicate a separately identifiable service
How OptiMantra helps with billing CPT Code 90836
For integrated practices offering both psychotherapy and medical services, accurate documentation and seamless billing are key. OptiMantra’s EMR and practice management platform is designed to support behavioral health and integrative care workflows, including:
- Time-based note templates for psychotherapy and E/M
- Automatic modifier and CPT pairing support
- Integrated telehealth for remote sessions
- Built-in claim scrubbing to reduce denials for time-based codes
- Easy reporting and audit trails for compliance
With OptiMantra, behavioral health professionals can streamline session documentation, ensure compliant coding, and submit clean claims—so they can focus more on patient care and less on paperwork.
Try OptiMantra for free here!
