CPT - Medera

CPT is the US standard for medical, surgical, and diagnostic procedures. Medera’s BH calibration covers psychotherapy, E/M, crisis intervention, family / group therapy, psychological testing, and CoCM codes.

Behavioral health CPT subset

Diagnostic evaluation

Code	Description
`90791`	Psychiatric diagnostic evaluation
`90792`	Psychiatric diagnostic evaluation with medical services

Psychotherapy (individual)

Code	Description
`90832`	Psychotherapy, 30 min
`90834`	Psychotherapy, 45 min
`90837`	Psychotherapy, 60 min
`90838`	Psychotherapy with E/M, 60 min

Crisis psychotherapy

Code	Description
`90839`	Crisis psychotherapy, first 60 min
`90840`	Crisis psychotherapy, each additional 30 min

Family / group

Code	Description
`90846`	Family psychotherapy without patient
`90847`	Family psychotherapy with patient
`90853`	Group psychotherapy

Assessment

Code	Description
`96127`	Brief emotional / behavioral assessment
`96130`	Psychological testing evaluation, first hour
`96131`	Psychological testing evaluation, each additional hour

E/M (established patient)

Code	Description
`99211` – `99215`	Established patient office visit, increasing complexity

CoCM (Collaborative Care)

Code	Description
`99491`	Care management, first 30 min
`99492` – `99494`	CoCM initial / subsequent / additional time
`G2214`	Behavioral health integration, 30 min

E/M level selection

The engine selects E/M level based on documented time + MDM per the 2021 office E/M guidelines. The selection rationale is included in the response:

{
  "code": "99214",
  "display": "Established patient E/M, moderate complexity",
  "em_selection_rationale": {
    "method": "time",
    "documented_minutes": 32,
    "threshold_range": "30-39 min"
  }
}

Telehealth modifier

For telehealth visits in 2026, append modifier 95 for synchronous audio-video. See payer-specific rules in the Prior Authorization Agent.

What’s next

ICD-10-CM

F-code diagnosis.

HCPCS Level II

BH-specific H- and S-codes.

Encounter coding

Per-encounter use cases.

Revenue cycle

Sweeps + audits.

​Behavioral health CPT subset

​Diagnostic evaluation

​Psychotherapy (individual)

​Crisis psychotherapy

​Family / group

​Assessment

​E/M (established patient)

​CoCM (Collaborative Care)

​E/M level selection

​Telehealth modifier

​What’s next