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Supported Line of Business: Commercial

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Individual outpatient psychotherapy and psychiatric diagnostic evaluation, delivered directly by a licensed behavioral health clinician — either non-prescribing (LCSW, LPC, LMFT, LMHC, or psychologist) or prescribing (psychiatrist, PMHNP, or PA) — billed under standard behavioral health CPT codes.

⚠️ Why Medicare Advantage isn't included yet: Medicare requires patients to complete an in-person (non-telehealth) visit within 6 months before their first behavioral health telehealth encounter, and at least annually thereafter. Bridge's BH Talk Therapy model is currently telehealth-only, so this guide is scoped to Commercial only until Bridge has a path to satisfy that in-person visit requirement for Medicare Advantage patients. (Note: CMS's enforcement of this rule has been delayed by Congress until 2028, but the underlying requirement remains part of Medicare's telehealth mental health policy.)

Overview

Behavioral Health Talk Therapy, also known as Psychotherapy, covers two distinct service types, both delivered personally by the billing clinician (not incident-to):

  1. Psychiatric Diagnostic Evaluation — a comprehensive intake assessment establishing diagnosis and treatment plan, billed once at the start of care (90791 for non-prescribing clinicians; 90792 — diagnostic evaluation with medical services — for prescribing clinicians).
  2. Individual Psychotherapy — ongoing outpatient talk therapy sessions, billed per encounter based on face-to-face psychotherapy time (90832, 90834, or 90837 for non-prescribing clinicians). Prescribing clinicians performing psychotherapy alongside a separately billed E/M visit instead use the add-on codes 90833, 90836, or 90838, which cannot be billed standalone.
Dimension Diagnostic Evaluation (90791/90792) Individual Psychotherapy (90832/90834/90837/90833/90836/90838)
Billing code 90791 (non-medical diagnostic evaluation) 90832 / 90834 / 90837, selected by time
Prescribing clinician equivalent 90792 (diagnostic evaluation, with medical services) Separate E/M code + psychotherapy add-on (90833/90836/90838, selected by time) — add-on cannot be billed standalone
When billed Once at intake Each subsequent session
Who can bill Any licensed independent BH clinician (non-prescribing); prescribing clinicians (MD/DO, NP, PA) bill 90792 instead Any licensed independent BH clinician within scope of practice; prescribing clinicians bill the add-on codes alongside their own separately billed E/M service instead
Level driver Completion of the diagnostic evaluation elements below Face-to-face psychotherapy time (not total time spent on the encounter like E/M)
Same-day billing Cannot be billed same day as 90832/90834/90837/90833/90836/90838 for the same patient (applies to 90791 and 90792) Cannot be billed same day as 90791/90792 for the same patient

Consent Requirements

Providers must obtain and document patient consent before initiating BH Talk Therapy. We recommend combining informed consent for Telehealth + Behavioral Health Talk Therapy services into one policy for operational simplicity.

⚠️ Psychotherapy notes vs. progress notes: HIPAA gives a therapist's private psychotherapy process notes (session-by-session subjective impressions, kept separate from the rest of the record) heightened protection and generally requires a separate patient authorization to release them. The TEXT field submitted to Bridge should contain a standard progress note (diagnosis, time, interventions, risk assessment, plan) — not verbatim psychotherapy process notes.

Service Frequency & Scope

Category Details
Payer eligibility Supported for Commercial only. Confirm your specific supported line of business with your Bridge Onboarding contact.
Provider types Independently licensed behavioral health clinician holding at least a master's degree (e.g., LCSW, LPC, LMFT, LMHC) or a licensed psychologist (PhD/PsyD, which exceeds the master's-level floor) — bills 90791/90832/90834/90837.

Prescribing clinicians (psychiatrist MD/DO, PMHNP, or PA with prescriptive authority) also qualify — they bill 90792 for the diagnostic evaluation, and 90833/90836/90838 as an add-on to their own separately billed E/M service for psychotherapy.

⚠️ Provisionally licensed, associate-level, or supervision-only clinicians do not qualify under Bridge — the billing clinician must hold full, independent state licensure and personally deliver the service (this is not an incident-to service under Bridge). | | Diagnostic evaluation frequency | Typically once per episode of care. Some payers will cover a repeat 90791/90792 only with documented clinical justification (e.g., significant change in presentation, gap in treatment, new course of care).

⚠️ Confirm payer-specific limits with your Bridge contact before repeating a diagnostic intake for the same patient. | | Psychotherapy session frequency | Typically, no fixed CPT-level visit cap. Bridge will flag claims should a benefit max be met — at no financial risk to you or the patient. | | Time expectation | Code selection (90832/90834/90837, or the add-on codes 90833/90836/90838 for prescribing clinicians) is driven by face-to-face psychotherapy time only — time spent specifically in the therapeutic interaction, not total encounter or documentation time. Minimum of 16 minutes in order to be billable. Time cannot be used to select the paired E/M level when 90833/90836/90838 is reported. | | Telehealth delivery | Synchronous audio-video required. Work with your Bridge Onboarding contact if you anticipate challenges with certain patient populations. |