Five codes that capture work you're already doing — but not getting paid for.

You just finished a 40-minute med check. You reviewed the PHQ-9 your patient completed in the waiting room, spent 20 minutes on CBT techniques for her anxiety, adjusted her SSRI, and documented the whole thing. You billed 99214.

That's not wrong. But it's incomplete.

Behavioral health visits routinely involve more than what a single E/M or therapy code captures. You're administering screeners, managing complex family dynamics, coordinating care across a longitudinal relationship. Most of that work never makes it onto a claim — not because it isn't billable, but because the add-on codes designed to capture it are chronically underused.

The reasons are predictable: the codes feel unfamiliar, documentation requirements seem unclear, and there's a vague sense that it's "probably bundled anyway." Often, it isn't.

Here's what you might be missing:

G2211 — Visit Complexity

This code captures the cognitive load of serving as a patient's ongoing point of care — managing their condition over time, not just treating what's in front of you today. If you're a psychiatrist or PMHNP providing continuous psychiatric care, this describes most of your established patient visits.

G2211 went live in January 2024, and CMS designed it expecting 38–54% of outpatient E/M visits to qualify. The actual national adoption rate? Somewhere between 5 and 10 percent.

That gap isn't because clinicians don't qualify — it's because the code is new, guidance has been sparse, and many practices haven't built it into their workflows yet. Practices with strong documentation systems are already capturing it at 40–50% of eligible visits, right where CMS intended.

Reimbursement: ~$16 per visit — modest in isolation, but $1,600+ per 100 visits at appropriate utilization.

90833 / 90836 / 90838 — Psychotherapy Add-Ons

These codes exist for prescribers who provide psychotherapy alongside medical management in the same visit. If you're doing a med check and spending 20 minutes on motivational interviewing, CBT techniques, or supportive psychotherapy, you can bill both.

The key is that the psychotherapy must be separately identifiable and documented with its own time. You're not double-billing — you're accurately reflecting two distinct services.

Many prescribers bill the E/M alone and assume the therapy component is included. It isn't. If you're consistently spending 20+ minutes on psychotherapy techniques during med management visits, you're leaving $70–115 per visit on the table. National billing rates suggest fewer than 5% of eligible visits capture these codes — but practices with detailed time documentation see 15–25%.

96127 — Behavioral Health Screening

This one is simple: if you're administering a standardized screening instrument — PHQ-9, GAD-7, AUDIT, Columbia Suicide Severity Rating Scale — and scoring it, you can bill 96127. It's not time-based. You bill per instrument, up to four per visit.

The reimbursement is small: roughly $5 per instrument. But if you're running a PHQ-9 and GAD-7 at every intake (and you probably are), that's two billable units you're likely not capturing.

The common assumption is that screening is "part of the visit." For most payers, it's separately billable — you just have to document the instrument used, the score, and your interpretation. Practices that systematically capture this code do so on 70–80% of eligible visits. Most practices? Under 15%.

90785 — Interactive Complexity

Interactive complexity applies when specific communication factors complicate your ability to deliver care. The classic scenarios: a child session with parents who have discordant views about treatment, a patient requiring an interpreter, or a session involving disclosure of abuse that triggers mandated reporting.

This code captures intensity, not time. It's an add-on to diagnostic evaluations or psychotherapy codes, and it reimburses around $15.

Industry estimates suggest 15–25% of psychotherapy sessions legitimately qualify for interactive complexity. Most practices bill it rarely, if ever — often because it feels like "double-dipping" or because the criteria seem fuzzy. They're actually fairly specific: if at least one of the qualifying factors is present and documented, you can bill it.

99417 — Prolonged Services

This one is niche, but worth knowing. If your visit time exceeds the threshold for the highest-level E/M code — 55 minutes for an established patient, 75 minutes for a new patient — you can bill 99417 (or G2212 for Medicare) for each additional 15-minute increment.

It requires explicit time documentation, which many EHRs don't prompt for automatically. But for complex intakes, crisis stabilization, or multi-issue visits that run long, it's a legitimate way to capture the actual work performed. Reimbursement runs $31–40 per 15-minute unit.

What This Adds Up To

For a typical prescriber practice, accurate add-on code capture can mean meaningful revenue recovery:

That's not from doing more work. It's from billing for work you're already doing.

The Takeaway

These aren't loopholes or aggressive billing tactics. They're codes designed to reflect the real complexity of behavioral health care — work you're already doing but not getting paid for.

The gap between what's billable and what's actually billed represents revenue left on the table. And unlike negotiating higher rates or adding new services, capturing these codes requires no new clinical work — just better documentation habits and billing workflows.

Start with one. Pick the code most relevant to your practice — probably G2211 or the psychotherapy add-ons if you're a prescriber — build it into your routine, and track the results for a month.

You might be surprised how much you've been leaving behind.

Questions about how these codes apply to your practice? We're happy to talk it through