CPT Codes for Mental Health Screening: 2026 Complete Guide
The primary CPT codes for mental health screening and psychological testing in 2026 are 96127 (brief emotional/behavioral assessment, $4.97/unit), 96138 (technician-administered testing, $37.73/30 min), 96136 (provider-administered testing, $43.94/30 min), and 96130 (testing evaluation, $124.74/hour). For Medicare Annual Wellness Visits, G0444 ($18.25) replaces 96127 for the depression screening component. All are billable to major insurers including Medicare and are approved for telehealth through December 31, 2026.
This guide covers every code a primary care practice needs for mental health screening and testing — from the initial screening through test administration and clinical evaluation. Each code has a detailed companion article linked below.
Complete Code Reference Table
| Code | Description | 2026 Medicare Rate | Time | Who Performs | Detailed Guide |
|---|---|---|---|---|---|
| 96127 | Brief emotional/behavioral assessment | $4.97/unit (max 3 = $14.91) | Per instrument | Physician or QHP | 96127 FAQ |
| G0444 | AWV depression screening | $18.25 | Per visit | Physician or QHP | 96127 FAQ |
| 96138 | Test administration by technician | $37.73/first 30 min | Time-based (min 16 min) | Technician (supervised) | 96138 FAQ |
| 96136 | Test administration by provider | $43.94/first 30 min | Time-based (min 16 min) | Physician or QHP | 96136 FAQ |
| 96130 | Testing evaluation | $124.74/first hour | Time-based (min 31 min) | Physician or QHP | 96130 FAQ |
Additional time codes: 96139 (additional 30-min units for technician administration), 96137 (additional 30-min units for provider administration), 96131 (additional hours for evaluation).
Understanding the Screening-to-Testing Workflow
These codes are not interchangeable — they represent distinct stages of mental health assessment, and understanding which code applies at each stage is the key to correct billing.
Stage 1: Brief Screening (CPT 96127)
The workflow begins with CPT 96127 — a brief screening using a standardized instrument. This is the high-volume code that most primary care practices use for routine mental health screening during office visits. The provider (or their staff, under supervision) administers a validated screening tool, scores it, documents the results, and bills 96127.
Each unit of 96127 represents one standardized instrument. With Connected Mind, a single screening session covers six conditions simultaneously — depression, anxiety, ADHD, bipolar disorder, substance use disorder, and somatic symptom disorder — supporting up to 3 units per visit ($14.91 at 2026 Medicare rates). Single-condition screeners like the PHQ-9 or GAD-7 typically support 1 unit.
The result of screening is a flag: positive or negative for each condition assessed. A positive screen is not a clinical finding — it indicates that further evaluation is warranted.
Stage 2: Targeted Testing (CPT 96136 or 96138)
When screening flags a positive result, the provider may order formal psychological testing on a subsequent visit. The test administration codes depend on who administers the tests:
- CPT 96136 ($43.94/first 30 min) — the physician or qualified healthcare professional administers the tests personally
- CPT 96138 ($37.73/first 30 min) — a technician administers the tests under the supervision of a physician or QHP
Both codes require a minimum of 16 minutes of total time and cover two or more tests administered by any method. If administration exceeds 30 minutes, bill additional 30-minute increments using 96137 (for provider) or 96139 (for technician).
Do not bill 96136 or 96138 on the same day as 96127. Screening and formal testing are separate encounters.
Stage 3: Clinical Evaluation (CPT 96130)
After tests are administered, the physician or qualified healthcare professional evaluates the results. CPT 96130 ($124.74/first hour) covers the cognitive work that only a clinician can perform:
- Integrating patient data with test results
- Interpreting standardized test scores
- Clinical decision-making and differential analysis
- Treatment planning
- Report writing
- Interactive feedback to the patient or caregiver
This is the highest-value code in the testing workflow. A minimum of 31 minutes of total time (not face time) must be spent to bill one unit. Additional hours are billed using 96131.
96130 may be performed on a different day from 96136/96138. The test administration and clinical evaluation do not need to occur in the same encounter.
When to Use Each Code
| Clinical Scenario | Code(s) | Notes |
|---|---|---|
| Routine screening during a regular office visit | 96127 | Up to 3 units per visit |
| Depression screening during Medicare Annual Wellness Visit | G0444 | Do not use 96127 — G0444 pays $18.25 |
| Technician administers formal testing after positive screen | 96138 | Separate visit from screening |
| Provider personally administers formal testing | 96136 | Separate visit from screening |
| Provider evaluates and interprets test results | 96130 | May be same day as 96136/96138 or separate |
| Full testing encounter (technician administers + provider evaluates) | 96138 + 96130 | Both billable same day |
| Full testing encounter (provider administers + evaluates) | 96136 + 96130 | Both billable same day |
Modifier Rules
Every mental health screening and testing code follows the same modifier pattern when billed alongside an Evaluation and Management (E&M) code:
- Bill the E&M code first with modifier 25 (significant, separately identifiable E&M service)
- Bill the screening/testing code last with modifier 59 (distinct procedural service)
This tells the payer that the screening or testing was a separate, distinct service from the office visit.
ICD-10 Code Pairing
For Screening (96127)
| Scenario | ICD-10 Code | Description |
|---|---|---|
| Depression screening, negative | Z13.31 | Encounter for screening for depression |
| Other mental health screening, negative | Z13.39 | Encounter for screening, other mental health |
| General behavioral screening, negative | Z13.89 | Encounter for screening, other specified |
| Positive depression screen | Z13.31 or F32.xx | Screening code or condition code |
| Positive anxiety screen | Z13.39 or F41.xx | Screening code or condition code |
For Testing (96130, 96136, 96138)
Medicare requires mental health-related ICD-10 codes — generally F-codes or codes for symptoms related to mental health conditions. Do not duplicate the ICD-10 codes from your E&M service, or the payer may consider the testing code bundled and deny payment.
Codes That Cannot Be Billed Together
| Code | Cannot Bill With | Reason |
|---|---|---|
| 96127 | 96130, 96136, 96138 | Brief screening vs. formal testing — different levels of service |
| 96127 | G0444 | G0444 replaces 96127 during AWVs |
| 96127 | 90791, 90792 | Psychiatric diagnostic evaluations already encompass screening |
| 96127 | 99406–99409 | Smoking/tobacco cessation counseling |
| 96127 | Psychotherapy codes | 90832, 90834, 90837, etc. |
| 96130, 96136, 96138 | 96127 | Cannot combine screening and testing same day |
| 96130, 96136, 96138 | 90791, 90792, psychotherapy codes | Service overlap |
Telehealth Billing
As of January 2026, CMS has approved all mental health screening and testing codes — 96127, 96130, 96136, and 96138 — for use with telemedicine through December 31, 2026. Providers conducting virtual visits can administer screening instruments remotely and bill with the appropriate telehealth modifier.
Connected Mind supports remote administration via patient portal or digital link during telehealth encounters. Data from more than 4,000 remote screening encounters demonstrated clinically nuanced results consistent with epidemiological expectations.
Documentation Requirements
While 96127 is designed as a high-volume code with minimal documentation burden, all screening and testing codes require records showing:
- Which standardized instrument(s) were administered
- The score for each instrument
- Clinical interpretation — whether results were positive or negative
- Time spent (required for time-based codes: 96130, 96136, 96138)
- Follow-up action taken based on results
For testing codes (96130, 96136, 96138), documentation should also include the clinical rationale for testing (typically a positive screening result) and a written report of findings.
Mental Health Parity Protections
Under the Mental Health Parity and Addiction Equity Act, payers should not impose additional barriers on mental health screening that exceed those for comparable medical screenings. If a payer requests prior authorization for routine mental health screening under 96127, or applies annual limits that do not exist for comparable medical screening codes, providers can challenge these requirements through parity law enforcement channels.
How Connected Mind Streamlines the Workflow
Connected Mind® with Fast Check® screens for six common co-occurring mental health conditions in approximately one minute, supporting up to 3 units of CPT 96127 per visit. When any condition screens positive, Connected Mind automatically launches Standardized Assessment Modules (SAMs) for that condition — the patient continues seamlessly from screening into targeted assessment without the provider needing to select and administer a separate instrument.
This multi-condition screening approach reduces the risk of missed comorbidities, which affect roughly 50% of patients with a mental health condition, while maximizing reimbursement through the standard CPT code framework described in this guide.
Official CMS Resources
Detailed Billing Guides
- CPT 96127 FAQ — Brief emotional/behavioral assessment billing guide
- CPT 96130 FAQ — Psychological testing evaluation services
- CPT 96136 FAQ — Test administration by a provider
- CPT 96138 FAQ — Test administration by a technician
- New CPT codes for psychological testing — Overview of the 2019 code restructuring
- Mental Health Parity Act — Your rights when payers deny claims
- How to bill for mental health screening — Step-by-step billing workflow
- Billing quick reference — All codes at a glance
Frequently Asked Questions
What CPT code do I use for mental health screening?
The primary CPT code for mental health screening is 96127 (brief emotional/behavioral assessment with scoring and documentation, per standardized instrument). As of 2026, Medicare reimburses $4.97 per unit with a maximum of 3 units per date of service ($14.91 total). For Medicare Annual Wellness Visits, use G0444 instead of 96127 for the depression screening component — G0444 pays $18.25.
What is the difference between CPT 96127, 96136, 96138, and 96130?
These codes represent different stages of mental health assessment. CPT 96127 is for brief screening (administering and scoring a standardized instrument like the PHQ-9 or Connected Mind). CPT 96136 and 96138 are for test administration — 96136 when a physician or qualified healthcare professional administers the tests, 96138 when a technician does so under supervision. CPT 96130 is for the evaluation component: interpreting results, integrating clinical data, clinical decision-making, and writing reports. 96127 cannot be billed on the same day as 96136, 96138, or 96130.
How much do mental health screening CPT codes pay in 2026?
2026 Medicare national average rates: CPT 96127 pays $4.97 per unit (max 3 units = $14.91 per visit). CPT 96138 pays $37.73 for the first 30 minutes of technician-administered testing. CPT 96136 pays $43.94 for the first 30 minutes of provider-administered testing. CPT 96130 pays $124.74 for the first hour of testing evaluation. G0444 pays $18.25 for depression screening during a Medicare Annual Wellness Visit. Commercial payer rates are typically higher.
Can I bill CPT 96127 and 96130 on the same day?
No. Most payers, including Medicare, will not reimburse both 96127 and 96130 (or 96136/96138) on the same date of service. CPT 96127 covers brief screening, while 96130, 96136, and 96138 cover formal psychological testing. These represent different levels of service and should not be combined on the same visit.
When should I use G0444 instead of CPT 96127?
Use G0444 only during a Medicare Annual Wellness Visit (AWV) for the depression screening component. G0444 pays $18.25 — significantly more than a single unit of 96127 ($4.97). For all other visit types — regular office visits, follow-ups, new patient visits, telemedicine — use CPT 96127. Never bill 96127 on the same day as a Medicare AWV.
Who can bill CPT codes for mental health screening?
Any physician or qualified healthcare professional (MD, DO, PA, NP, DNP, PhD, PsyD) may bill 96127, 96136, and 96130. For 96138, the supervising physician or QHP bills on behalf of the technician who performed the test administration. Therapists, Licensed Professional Counselors, and Licensed Social Workers generally cannot bill these codes under CMS guidelines because the CPT codes used for their services already include uncovering or monitoring mental health conditions.
What ICD-10 codes do I use with mental health screening CPT codes?
For screening (96127), most payers accept Z13.xx codes: Z13.31 (screening for depression), Z13.39 (screening for other mental health conditions), Z13.89 (screening for other specified conditions). Use Z13.xx when results are negative. When results are positive, you may use Z13.xx or the appropriate F-code (e.g., F32.xx for depression, F41.xx for anxiety). For testing codes (96130, 96136, 96138), Medicare requires mental health F-codes — do not duplicate the ICD-10 codes from your E&M service.
Are mental health screening CPT codes approved for telehealth in 2026?
Yes. As of January 2026, CMS has approved CPT 96127, 96130, 96136, and 96138 for use with telemedicine through December 31, 2026. Providers conducting virtual visits can administer screening instruments remotely and bill with the appropriate telehealth modifier.
What modifiers do I need when billing mental health screening codes?
When billing any mental health screening or testing code alongside an Evaluation and Management (E&M) code: bill the E&M code first with modifier 25 (significant, separately identifiable E&M service), then bill the screening or testing code with modifier 59 (distinct procedural service). This tells the payer the screening was a separate, distinct service from the office visit.
How many units of CPT 96127 can I bill per visit?
The Medically Unlikely Edit (MUE) limit is 3 units of 96127 per date of service. Each unit represents one standardized screening instrument administered and scored. CMS does not limit how many times per year 96127 may be billed, though individual payers may impose their own annual limits. With Connected Mind, a single screening session covers six conditions, supporting up to 3 units per visit ($14.91 at 2026 Medicare rates).
What is the billing workflow when screening leads to testing?
When a brief screening (96127) flags a positive result and the provider orders formal testing on a subsequent visit, the testing workflow uses different codes: 96136 or 96138 for test administration, and 96130 for evaluation. These testing codes should not be billed on the same day as 96127. The testing and evaluation can be performed on different days from each other — for example, a technician administers tests on Monday (96138) and the provider evaluates results on Wednesday (96130).
Can Connected Mind billing use all of these CPT codes?
Connected Mind's screening session bills under CPT 96127 (up to 3 units per visit). When screening flags a positive result, Connected Mind automatically launches Standardized Assessment Modules (SAMs) for that condition. The SAMs component of Connected Mind may be billable under 96136 or 96138 depending on who administers it, and the clinical interpretation under 96130 — following the standard screen-then-test billing workflow. The screening (96127) and testing (96136/96138/96130) should be billed on separate dates of service.
What CPT codes cannot be billed together for mental health screening?
Do not bill 96127 on the same day as 96130, 96136, 96138, G0444 (use G0444 instead of 96127 during AWVs), 90791, 90792, 99406–99409, or any psychotherapy codes. Do not bill 96130, 96136, or 96138 alongside 96127, 90791, 90792, 99406–99409, or psychotherapy codes. These exclusions exist because the services overlap or are already encompassed by the other code.