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The FY 2026 CMS ICD-10-CM code set for Chapter 5 (F01–F99) is effective October 1, 2026, through September 30, 2027. Psychiatric diagnoses should be reported at the highest level of specificity supported by the documentation, including episode type, severity, psychotic features, remission status, or substance involved. Each code should be verified against the current CMS files before use, particularly when documentation supports more than one coding option. Accurate diagnosis selection also supports compliant psychiatric billing services by aligning clinical documentation with reported ICD-10-CM codes.
Psychiatric ICD-10-CM coding often depends on diagnostic details that distinguish closely related conditions. Review the provider's documented diagnosis and all required clinical qualifiers before selecting the most specific code.
For psychiatric diagnoses that require additional qualifiers, check whether the documentation identifies:
When the documentation does not support a required level of specificity, do not infer severity, psychotic features, remission, substance involvement, or another diagnostic detail. Use the code supported by the available documentation and follow the applicable ICD-10-CM guidelines.
The F01–F99 range covers mental, behavioral, and neurodevelopmental disorders. Understanding these code ranges helps identify the appropriate ICD-10-CM category before selecting the most specific diagnosis code.
Psychiatric code selection depends on the level of diagnostic detail documented in the medical record. Apply the following principles when reviewing F01–F99 codes:
The F01–F99 range covers mental, behavioral, and neurodevelopmental disorders, with code selection often depending on diagnosis, episode, severity, psychotic features, remission status, substance involved, or other documented characteristics. The following codes provide a practical reference for commonly encountered psychiatric diagnoses.
Mood disorder coding requires attention to the documented disorder, episode type, severity, psychotic features, and remission status where applicable.
Coding guidance: Confirm single versus recurrent depression from the provider's documented diagnostic history. Severity, psychotic features, and remission status should not be inferred from symptoms alone.
Coding guidance: Select the F31.- code according to the provider-documented current episode, severity, psychotic features, and remission status.
These categories include anxiety, phobic, obsessive-compulsive, trauma-related, dissociative, and somatic symptom disorders.
Coding guidance: PTSD coding should reflect documented duration/status. Adjustment disorder requires documentation supporting the condition and associated stressor. Do not assign acute, chronic, or other specific status without supporting documentation.
Substance-related coding requires identification of both the substance and the documented condition, such as abuse, dependence, intoxication, withdrawal, or remission.
Examples include:
Coding guidance: Do not interchange abuse, dependence, intoxication, withdrawal, or remission codes. Select the documented substance and condition supported by the record.
Psychotic disorder coding depends on the specific diagnosis documented by the provider rather than isolated symptoms.
Coding guidance: Confirm the documented psychotic disorder and, for schizoaffective disorder, the documented bipolar or depressive type before selecting the final code.
These codes cover mental disorders associated with known physiological conditions and require attention to the underlying medical cause.
Coding guidance: Follow the applicable code-first, use additional code, and sequencing instructions for the underlying physiological condition. Do not treat these codes as interchangeable with primary psychiatric disorders. CMS's official guidelines specifically address sequencing and additional-code requirements within this category.
This range includes eating disorders and behavioral syndromes associated with physiological disturbances or physical factors.
Coding guidance: Review the documented eating disorder type and applicable severity or other required specificity before selecting the final code.
These codes require a documented diagnosis rather than coding from an isolated behavioral observation.
Coding guidance: Use the specific personality or behavioral disorder documented by the provider. Avoid assigning a personality disorder from a single encounter or isolated behavior.
These categories cover intellectual disabilities and developmental disorders, including autism and other developmental conditions.
Coding guidance: Select the developmental diagnosis and level of specificity documented in the current assessment. Do not infer an intellectual-disability severity level when the record does not establish it.
These codes cover ADHD, conduct disorders, emotional disorders, and other behavioral conditions with typical onset during childhood or adolescence.
Coding guidance: For ADHD, select the documented presentation rather than defaulting to F90.9 when the provider establishes a specific type.
F99 should be used only when the documentation supports an unspecified mental disorder and a more specific diagnosis cannot be established from the available record.
Z codes may supplement an F-code when a documented psychosocial circumstance, counseling need, or long-term treatment factor is relevant to the current encounter.
Coding guidance: Do not add Z codes routinely. Report them when the documented circumstance is relevant to the current encounter and meets the applicable ICD-10-CM reporting requirements.
Important: This quick reference should not replace review of the FY 2027 CMS ICD-10-CM Tabular List, Alphabetic Index, and Official Guidelines. The code set is effective October 1, 2026, and CMS provides the current files for verification before reporting.
Psychiatry and Psychology are specialised fields for the diagnosis and treatment of various mental health disorders and/or diseases. References to providers include physicians and nonphysicians, such as clinical psychologists, independent psychologists, nurse practitioners, clinical nurse specialists and physician assistants when the services performed are within the scope of their state licence and clinical practice/education. Individual psychotherapy CPT codes should be used only when the focus of treatment involves individual psychotherapy. Psychiatric service CPT codes should not be used when other CPT codes such as an evaluation and management (E/M) service or pharmacological codes are more appropriate.
Individual psychotherapy CPT codes should be used only when the focus of treatment involves individual psychotherapy. These CPT codes should not be used as generic psychiatric service CPT codes when other CPT codes such as an evaluation and management (E/M) service or pharmacological codes would be more appropriate.
Family psychotherapy services are covered only where the primary purpose of such Psychotherapy is the treatment of the patient’s condition. Examples include:
CPT code 90849 represents multiple-family group psychotherapy and would generally be non covered by Medicare. Such group therapy is directed to the effects of the patient’s condition on the family, and does not meet Medicare’s standards of being part of the provider's personal services to the patient. Claims for 90849 may be approved on an individual consideration basis. CMS Publication 100-03; Medicare National Coverage Determinations Manual, Chapter 1, § 70.1 Psychiatric services must be performed by a qualified healthcare provider. See PSYCH-013 for incident to psychiatric services guidelines.
An E/M service may be substituted for the initial interview procedure, including consultation CPT codes, (CPT codes 99241-99263), provided required elements of the E/M service billed are fulfilled. Consultation services require, in addition to the interview and examination, the provision of a written opinion and/or advice. E/M CPT codes do not include a psychotherapy service.
CPT codes 90802, 90810-90815, 90823-90829 and 90857 may also be covered for any psychiatric disorder as specified in the “ICD-9-CM codes that Support Medical Necessity” section for adults who also have one of the conditions as specified in the Local Coverage Determination. Both the primary psychiatric diagnosis and secondary communication disorder must be submitted on the claim.
These CPT codes represent insight-oriented, behaviour-modifying, supportive, and/or interactive psychotherapy. Of these, CPT codes 90805, 90807, 90809, 90811, 90813, 90815, 90817, 90819, 90822, 90824, 90827, and 90829 include medical evaluation and management (E/M) services including continuing medical diagnostic evaluation as well as pharmacological management. Therefore, the same healthcare provider may not bill pharmacological management (90862) and E/M service CPT codes separately on the same day as a psychotherapy service.
CPT codes 90846 and 90847 represent psychotherapy services for the treatment of mental disorders. They should not be used when the service performed is taking a family history or E/M counselling services. E/M counselling services should be coded with the appropriate E/M CPT code according to the time involved. Family counselling does not include the supervision of or therapy with professional caretakers or staff.
The guidelines in the “Documentation” section under CPT codes 90804 through 90829 (psychotherapy) apply to CPT code 90853 - group psychotherapy. It is recommended that the time of the therapy also be documented. To establish medical necessity of the service, claims must be submitted with a covered diagnosis.
CPT code 90862 is intended to refer to a visit that is focused on the monitoring and prescribing of psychopharmacologic agents. Relevant history is obtained, a mental status examination is performed, and medical decision making (i.e., assessment of treatment response and ongoing treatment formulation) occurs during such a visit providing all of the elements are documented. Psychopharmacologic agents may be initiated or adjusted during such a visit.
CPT codes 90875 and 90876 are described as individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with patient), with psychotherapy (e.g., insight oriented, behaviour modifying or supportive psychotherapy).
Medicare does not cover biofeedback for the treatment of psychosomatic disorders.
CPT codes 90810-90815 and 90823-90829 should not be billed on the same dates of service as CPT codes 90804-90809 or 90816-90822.
CPT code 90857 should not be billed on the same date of service as 90853. CPT code 90857 should also not be billed more than once per day for the same beneficiary unless he/she has participated in a separate and distinct group therapy session.
In the infrequent event that a patient has a separate and distinct individual psychotherapy and group therapy session in one day, modifier -59 should be appended to the CPT code for the second session.
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