ICD-10 Codes for Common Mental Health Conditions: Billing Reference Guide

Mental health ICD-10 coding is not just a code lookup task. The diagnosis code must correspond with the provider’s note, the service billed and the amount of detail known at that visit. This 2026 billing reference provides U.S. mental health practices with a useful reference for the most frequent ICD-10-CM codes, documentation concerns, and coding errors that may impact mental health claims.

A patient’s depression, anxiety, trauma symptoms, substance use, sleep and medication management needs may all occur in the context of billing work. A vague code can slow down the payment or cause a code review from the payer or weaken the claim’s strength compared to the note’s strength.

2026 update note: This guide covers U.S. ICD-10-CM coding for FY 2026. For encounters from April 1, 2026 through September 30, 2026, use the official April 1, 2026 ICD-10-CM update files and guidelines. Always verify the final code in the current ICD-10-CM Tabular List before submitting a claim.

What Are ICD-10 Codes for Mental Health?

ICD-10-CM codes are diagnosis codes used in the United States to specify the condition of a patient in a claim, report, for medical necessity, and for healthcare records. 

Codes are used to indicate diagnoses, which include depression, anxiety disorders, bipolar disorder, PTSD, ADHD, schizophrenia, substance use disorders, eating disorders, and adjustment disorders where mental health billing is concerned.

The majority of diagnosis codes in mental health will be in the F01-F99 category. The title of this chapter is Mental, Behavioral and Neurodevelopmental Disorders according to ICD-10-CM.

In billing, the ICD-10-CM code answers this question:

Why was the patient treated?

The CPT or HCPCS code answers a different question:

What service was provided?

For example, a therapist may bill a psychotherapy CPT code such as 90834 or 90837, while the ICD-10-CM code explains the diagnosis supporting that service. 

CMS behavioral health billing references include psychiatric diagnostic evaluation codes, psychotherapy codes, psychotherapy add-on codes, and group psychotherapy codes used with mental health services. Both codes should match the provider’s note.

Billable vs Non-Billable ICD-10-CM Codes

ICD-10-CM includes categories, subcategories, and final reportable codes. A category such as F31 or F50 can help you find the right code family, but it may not be valid for claim submission.

For billing, use the final billable code supported by the provider’s note. If a code family has more detailed options, confirm the exact code in the current ICD-10-CM Tabular List before submitting the claim.

This matters because a code list may show a code family for navigation, while the claim requires a full code. The golden rule is to pick the “most specific” code based on the documentation, without including any unnecessary information.

Why ICD-10 Accuracy Matters in Mental Health Billing

Proper ICD-10 coding ensures a better understanding of why care was required. It also aids in treatment plans, authorizations, audits, reporting and patient records.

A common problem in mental health billing is not that the provider picked a completely wrong diagnosis. In most cases, the documentation just isn’t specific enough for the claim.

Code F41.1 is more specific than F41.9 when the notation is for generalized anxiety disorder. But if there isn’t enough information in the record for a certain anxiety disorder, then a code F41.9 can be used.

CMS confirms that sign, symptom, and unspecified codes are acceptable when they most accurately reflect what is known during that encounter. It is also inappropriate to select a more specific code that is not supported by the record.

It is important in therapy, psychiatry and behavioral health intake. It can take a longer time for the clinician to determine if the symptoms are due to major depressive disorder, adjustment disorder, bipolar disorder, PTSD, grief, substance-induced symptoms or another disorder. Coding should follow what the provider can support at that visit.

How to Choose the First-Listed Mental Health Diagnosis

For outpatient mental health claims, the main mental health condition, problem or reason for the services provided during the visit should generally be the first listed diagnosis.

When the note contains a focus on the symptoms of PTSD, PTSD should typically be listed first. Depression, anxiety and substance use disorders are included as additional diagnoses if the patient has these disorders; if the disorders do not affect the care, treatment, or management during that encounter, they are not included here.

If the provider hasn’t officially diagnosed the condition, the first diagnosis listed might be less specific for intake visits. If so, then code the highest level of certainty found in documentation of that visit, including symptoms, unspecified diagnosis or reason for encounter. The official guidelines also state that the entire record should be reviewed to determine the reason for the encounter and the conditions treated.

Common Mental Health ICD-10 Codes: Quick Billing Table

Use this table as a fast reference. Code families are shown for navigation only. Do not submit a code family or range on a claim. Select the exact billable ICD-10-CM code supported by the provider’s note and the current ICD-10-CM Tabular List.

Code Family	Condition	Common ICD-10-CM Examples	Billing Note
F32.-	Major depressive disorder, single episode	F32.0, F32.1, F32.2, F32.3, F32.4, F32.5, F32.9	Code severity, psychotic features, or remission when documented.
F32.A	Depression, unspecified	F32.A	Use when depression is documented but does not support a more specific depressive disorder code.
F33.-	Major depressive disorder, recurrent	F33.0, F33.1, F33.2, F33.3, F33.40, F33.41, F33.42, F33.9	Document recurrence, severity, remission status, and psychotic features if present.
F41.-	Generalized anxiety disorder	F41.1	Use when the record supports generalized anxiety disorder rather than general anxiety symptoms.
F41.-	Panic disorder	F41.0	Use when panic disorder is documented and supported.
F41.-	Anxiety disorder, unspecified	F41.9	Use when anxiety is documented but the type is not yet specified.
F40.-	Social phobia	F40.10, F40.11	Use F40.10 for unspecified social phobia and F40.11 for generalized social phobia.
F42.-	Obsessive-compulsive disorder	F42.2, F42.8, F42.9	Select the most specific OCD code supported by documentation.
F43.-	Post-traumatic stress disorder (PTSD)	F43.10, F43.11, F43.12	Document whether PTSD is unspecified, acute, or chronic when known.
F43.-	Acute stress reaction	F43.0	Use when the record supports acute stress reaction.
F43.-	Adjustment disorder	F43.20, F43.21, F43.22, F43.23, F43.24, F43.25, F43.29	Code the dominant presentation when documented.
F31.-	Bipolar disorder	F31 code family	Select the exact code based on current or most recent episode, severity, psychotic features, and remission status.
F90.-	ADHD	F90.0, F90.1, F90.2, F90.8, F90.9	Match inattentive, hyperactive/impulsive, combined, other, or unspecified type.
F84.-	Autism spectrum disorder	F84.0	Use when supported by diagnostic history and functional documentation.
F20.-	Schizophrenia	F20 code family	Select the specific schizophrenia code when documented.
F25.-	Schizoaffective disorder	F25.0, F25.1, F25.9	Specify bipolar type, depressive type, or unspecified.
F10.-	Alcohol use disorders	F10.10, F10.20, F10.21 and related codes	Follow use, abuse, dependence, remission, and complication rules.
F11.-	Opioid use disorders	F11.10, F11.20, F11.21 and related codes	Document use, abuse, dependence, remission, and associated complications.
F12.-	Cannabis-related disorders	F12.10, F12.20, F12.21 and related codes	Match the code to use, abuse, dependence, remission, or complications.
F50.-	Eating disorders	Refer to the current FY 2026 ICD-10-CM Tabular List for the exact billable code.	Verify the exact billable code based on the documented diagnosis, severity, remission status, and current ICD-10-CM updates before claim submission.

Depression ICD-10 Codes

Depression coding is one of the most common areas where mental health claims become too vague. 

ICD-10 diagnosis codes for depression depend on whether documentation supports depressive symptoms, unspecified depression, single-episode major depressive disorder, or recurrent major depressive disorder.

Major Depressive Disorder, Single Episode

For a single episode of major depressive disorder, common codes include:

Code	Description
F32.0	Major depressive disorder, single episode, mild
F32.1	Major depressive disorder, single episode, moderate
F32.2	Major depressive disorder, single episode, severe without psychotic features
F32.3	Major depressive disorder, single episode, severe with psychotic features
F32.4	Major depressive disorder, single episode, in partial remission
F32.5	Major depressive disorder, single episode, in full remission
F32.9	Major depressive disorder, single episode, unspecified
F32.A	Depression, unspecified

Major Depressive Disorder, Recurrent

For recurrent major depressive disorder, common codes include:

Code	Description
F33.0	Major depressive disorder, recurrent, mild
F33.1	Major depressive disorder, recurrent, moderate
F33.2	Major depressive disorder, recurrent, severe without psychotic features
F33.3	Major depressive disorder, recurrent, severe with psychotic features
F33.40	Major depressive disorder, recurrent, in remission, unspecified
F33.41	Major depressive disorder, recurrent, in partial remission
F33.42	Major depressive disorder, recurrent, in full remission
F33.9	Major depressive disorder, recurrent, unspecified

The note should be very simple in the case of a depression claim. This is whether it is a recurrent episode or a single episode, severity of symptoms, whether the patient is in remission, and the effect of the condition on the individual’s life.

Anxiety Disorder ICD-10 Codes

When coding anxiety, it is best to separate general anxiety symptoms from an anxiety disorder. Many people say that problems occur when F41.9 is used over and over and the provider has provided a more specific diagnosis.

These anxiety-related diagnoses represent some of the most commonly billed Behavioral health ICD-10 codes in outpatient behavioral health settings.

Code	Description	When It Fits
F41.1	Generalized anxiety disorder	Ongoing excessive anxiety or worry supported by clinical documentation
F41.0	Panic disorder	Recurrent panic attacks or panic disorder documentation
F41.3	Other mixed anxiety disorders	Mixed anxiety presentation not better captured elsewhere
F41.8	Other specified anxiety disorders	A specified anxiety disorder that does not fit another code
F41.9	Anxiety disorder, unspecified	Anxiety is documented, but the specific disorder is not yet known

When the patient is currently undergoing assessment, an unspecified code may be applicable in this case. Otherwise, if there is documentation of GAD, panic disorder, social anxiety disorder, or any other particular disorder, the diagnosis must reflect such.

PTSD, Stress, and Adjustment Disorder Codes

Trauma coding needs careful review. PTSD, acute stress reaction, adjustment disorder, anxiety, depression, and substance use can share similar symptoms.

Code	Description
F43.0	Acute stress reaction
F43.10	Post-traumatic stress disorder, unspecified
F43.11	Post-traumatic stress disorder, acute
F43.12	Post-traumatic stress disorder, chronic
F43.20	Adjustment disorder, unspecified
F43.21	Adjustment disorder with depressed mood
F43.22	Adjustment disorder with anxiety
F43.23	Adjustment disorder with mixed anxiety and depressed mood
F43.24	Adjustment disorder with disturbance of conduct
F43.25	Adjustment disorder with mixed disturbance of emotions and conduct
F43.29	Adjustment disorder with other symptoms

Many code lists stop at F43.10 or F43.23. That will facilitate the process of lookup but not necessarily help a biller determine whether a note mentions PTSD, acute stress reaction, or adjustment disorder. Stressor and/or trauma, symptom pattern (if applicable), duration, clinical impact, stressor/trauma focus of diagnosis and treatment for more robust billing.

Bipolar Disorder ICD-10 Codes

Bipolar coding should not stop at “bipolar disorder” when the record supports more detail. The current or most recent episode matters. The note should show whether the episode is hypomanic, manic, depressed, mixed, in remission, or unspecified.

Code	Description
F31.0	Bipolar disorder, current episode hypomanic
F31.11	Bipolar disorder, current episode manic without psychotic features, mild
F31.12	Bipolar disorder, current episode manic without psychotic features, moderate
F31.13	Bipolar disorder, current episode manic without psychotic features, severe
F31.2	Bipolar disorder, current episode manic severe with psychotic features
F31.31	Bipolar disorder, current episode depressed, mild
F31.32	Bipolar disorder, current episode depressed, moderate
F31.4	Bipolar disorder, current episode depressed, severe without psychotic features
F31.5	Bipolar disorder, current episode depressed, severe with psychotic features
F31.9	Bipolar disorder, unspecified

Before choosing a bipolar code, review the note for episode type, mood symptoms, severity, psychotic features, remission status, medication management, safety concerns, and the reason for the encounter.

ADHD ICD-10 Codes

ADHD codes are common in child, adolescent, and adult behavioral health practices. The coding problem is usually not the diagnosis itself, but the missing presentation type.

Code	Description
F90.0	Attention-deficit hyperactivity disorder, predominantly inattentive type
F90.1	Attention-deficit hyperactivity disorder, predominantly hyperactive type
F90.2	Attention-deficit hyperactivity disorder, combined type
F90.8	Attention-deficit hyperactivity disorder, other type
F90.9	Attention-deficit hyperactivity disorder, unspecified type

Documentation for ADHD billing needs to include the ADHD diagnosis, the clinical basis, the impact, the treatment plan, the medication status if applicable, the impact on a child’s school or work, and follow up needs. If assessment tools, history reviewed, collateral information and clinical findings are part of the service, the provider should also document these for evaluations.

Schizophrenia and Psychotic Disorder Codes

Psychotic disorder codes often affect care plans, medication management, higher-acuity services, and payer reviews. These diagnoses are not interchangeable. The note should clearly support the condition being billed.

Code	Description
F20.0	Paranoid schizophrenia
F20.1	Disorganized schizophrenia
F20.2	Catatonic schizophrenia
F20.3	Undifferentiated schizophrenia
F20.5	Residual schizophrenia
F20.9	Schizophrenia, unspecified
F25.0	Schizoaffective disorder, bipolar type
F25.1	Schizoaffective disorder, depressive type
F25.9	Schizoaffective disorder, unspecified

Substance Use Disorder ICD-10 Codes

Substance use codes require caution because, with the ICD-10-CM, there is a hierarchical order of use, abuse, and dependence codes. In cases where use, abuse, and dependence are documented for the same substance, only one code is to be used. CMS states that abuse takes priority over use, and dependence takes priority over abuse or use when both are documented.

The remission rule is also important. For substance use categories F10–F19, “in remission” codes require the provider’s clinical judgment and must be assigned based on provider documentation unless the classification gives another instruction. 

Mild substance use disorders in remission are classified to abuse-in-remission codes, while moderate or severe substance use disorders in remission are classified to dependence-in-remission codes.

Substance Group	Common Code Examples	Documentation Needed
Alcohol-related disorders	F10.10, F10.20, F10.21	Use, abuse, dependence, remission, intoxication, withdrawal, or complications
Opioid-related disorders	F11.10, F11.20, F11.21	Severity, remission, medication treatment, withdrawal, intoxication, or complications
Cannabis-related disorders	F12.10, F12.20, F12.21	Pattern of use, dependence, remission, and associated disorder
Sedative, hypnotic, or anxiolytic disorders	F13.10, F13.20, F13.21	Substance class, dependence, withdrawal risk, remission
Cocaine-related disorders	F14.10, F14.20, F14.21	Use pattern, dependence, remission, intoxication, or complications
Other stimulant-related disorders	F15.10, F15.20, F15.21	Substance type, severity, remission, and related mental health effects

Unspecified psychoactive substance use codes should not be used casually. CMS states that unspecified psychoactive substance use codes should be assigned only when provider documentation supports them and when they meet the definition of a reportable diagnosis.

Eating Disorder ICD-10 Codes

Eating disorder coding has become more specific in recent code sets, so older cheat sheets may not be enough. For 2026 billing, practices should verify whether severity-specific codes are available and supported in the medical record.

Condition	Coding Guidance
Eating disorders	Use the current F50.- code structure that matches the provider’s documented diagnosis, severity, remission status, and other required clinical details. Because ICD-10-CM code options may change with annual updates, verify the exact billable code in the applicable FY 2026 ICD-10-CM Tabular List before claim submission.

The CDC/NCHS FY26 April 1, 2026 files include official code descriptions and code-set materials, which should be used as the source of truth when confirming valid codes for current billing.

ICD-10 and CPT Codes: How They Work Together

A mental health claim usually requires both diagnosis and procedure coding. While ICD-10-CM identifies why the patient received care, CPT and HCPCS represent the service performed. Together, these behavioral health billing codes support medical necessity and reimbursement.

CPT / HCPCS Code	Common Use	Documentation Note
90791	Psychiatric diagnostic evaluation	Document history, presenting problems, mental status, diagnosis or clinical impression, risk, and treatment need.
90792	Psychiatric diagnostic evaluation with medical services	Document assessment, medical services, medication-related findings when relevant, and treatment plan.
90832	Psychotherapy, 30 minutes	CMS lists 16–37 minutes. Document start/stop time or total time.
90834	Psychotherapy, 45 minutes	CMS lists 38–52 minutes. Document start/stop time or total time.
90837	Psychotherapy, 60 minutes	CMS lists 53 minutes or more. Document time and medical necessity.
90833	Psychotherapy add-on with E/M	Document psychotherapy time and E/M work separately.
90836	Psychotherapy add-on with E/M	Document psychotherapy time and E/M work separately.
90838	Psychotherapy add-on with E/M	Document psychotherapy time and clinical need.
90853	Group psychotherapy	Document group service, patient participation, treatment focus, and progress.

The ICD-10-CM diagnosis still needs to support why the patient received the service. For example, F41.1 may support a generalized anxiety disorder visit, while 90834 describes a 45-minute psychotherapy session. 

Mental Health Claim Review Checklist

Use this checklist before submitting a mental health claim. It combines documentation review and code-selection logic into one workflow.

What to Check	Why It Matters
Confirm the main reason for the visit.	Supports the first-listed diagnosis.
Check whether the diagnosis is confirmed or still uncertain.	Helps avoid coding rule-out diagnoses in outpatient care.
Review severity, episode, recurrence, and remission status.	Needed for depression, bipolar disorder, eating disorders, and substance use codes.
Match the ICD-10-CM code to the service billed.	Helps support medical necessity.
Review symptoms and functional impact.	Shows why care was needed.
Confirm the treatment plan and progress.	Supports ongoing therapy or psychiatric care.
Check coexisting conditions.	Add them only when they affect care, treatment, or management.
Confirm CPT time documentation when billing psychotherapy.	Supports codes such as 90832, 90834, and 90837.

The official guidelines state that the entire record should be reviewed to determine the specific reason for the encounter and the conditions treated.

Common ICD-10 Coding Mistakes in Mental Health Billing

1. Using unspecified codes when the note supports a specific diagnosis

Unspecified codes are not always wrong, but they should reflect what is truly known at the encounter. If the provider documents generalized anxiety disorder, recurrent major depressive disorder, or chronic PTSD, the billing code should not stay vague.

2. Coding a suspected diagnosis in outpatient care

In outpatient coding, do not code diagnoses described only as probable, suspected, questionable, rule out, compatible with, consistent with, or working diagnosis. Code the condition to the highest degree of certainty known at the visit.

3. Billing category headers instead of complete codes

A three-character code is valid only when it is not further subdivided. If more characters are required, the code is invalid unless reported to the full required length.

4. Ignoring substance use hierarchy

If the same substance is documented as use, abuse, and dependence, dependence is coded rather than reporting multiple pattern codes for the same substance.

5. Letting diagnosis and treatment plan drift apart

If the treatment plan focuses on panic attacks, trauma symptoms, or recurrent depression, the diagnosis section should support that focus. Diagnosis, assessment, plan, and claim should tell the same story.

Billing Examples

Anxiety Intake

A new patient reports constant worry, poor sleep, and trouble focusing. The provider documents anxiety but has not confirmed generalized anxiety disorder.

Better coding choice: F41.9 may be appropriate if anxiety disorder is documented but not yet specified.

Avoid: F41.1 unless the note supports generalized anxiety disorder.

Depression Follow-Up

The note documents recurrent major depressive disorder, moderate, with ongoing symptoms.

Better coding choice: F33.1

Avoid: F32.A or F33.9 when the note clearly supports recurrent moderate MDD.

Rule-Out PTSD

The provider writes “rule out PTSD” and documents nightmares, avoidance, and trauma history.

Better coding choice: Code the symptoms or highest confirmed condition for that outpatient visit.

Avoid: F43.10 unless PTSD is documented as confirmed.

Coexisting Conditions

The session focuses on panic attacks, but the patient also has a history of depression that is not assessed or treated that day.

Better coding choice: List the panic-related diagnosis first when supported.

Avoid: automatically listing every past diagnosis if it does not affect care during the visit.

Sources Used for This Billing Reference

This guide was built using official and primary coding sources, including:

• CMS ICD-10-CM FY 2026 files and update guidance
• CDC/NCHS ICD-10-CM April 1, 2026 release files
• FY 2026 ICD-10-CM Official Guidelines for Coding and Reporting
• CMS Medicare Coverage Database guidance for psychiatric diagnostic evaluation and psychotherapy services

CMS and CDC/NCHS should be treated as the main source of truth for ICD-10-CM code validity and update windows. CMS billing guidance should be checked for Medicare psychiatric diagnostic evaluation and psychotherapy billing requirements.

Frequently Asked Questions

1. What are the most common ICD-10 codes for anxiety and depression?

Common ICD-10-CM codes for anxiety and depression include F41.1 for generalized anxiety disorder, F41.9 for anxiety disorder unspecified, F32.A for depression unspecified, F32.1 for major depressive disorder single episode moderate, and F33.1 for recurrent major depressive disorder moderate. The final code should match the provider’s documentation, diagnosis type, severity, episode, and remission status.

2. What are the differences between ICD-9 and ICD-10 for mental health?

ICD-10-CM replaced ICD-9-CM for U.S. diagnosis coding and uses a more detailed code structure. For mental health, ICD-10-CM provides broader specificity for diagnosis categories, severity, episode status, remission, and related clinical detail. In current U.S. billing, mental health practices should use ICD-10-CM, not ICD-9-CM, for diagnosis reporting.

3. What ICD-10 code is used for generalized anxiety disorder?

The ICD-10-CM code for generalized anxiety disorder is F41.1. Use it when the provider’s note supports GAD rather than general anxiety symptoms. If the provider documents anxiety but does not confirm the specific anxiety disorder, F41.9 may be more appropriate.

4. What ICD-10 code is used for depression?

Depression coding depends on the diagnosis detail. F32.A is used for depression, unspecified. Major depressive disorder uses F32 codes for a single episode and F33 codes for recurrent episodes. When documented, the code should reflect severity, psychotic features, and remission status.

5. What is the process for billing mental health services using ICD-10?

The process starts with the provider’s documented diagnosis or reason for the visit. Then the billing team selects the ICD-10-CM code supported by the note, matches it with the correct CPT or HCPCS service code, checks payer rules, verifies time documentation for psychotherapy when required, and submits the claim. CMS billing guidance references psychiatric diagnostic evaluation codes, psychotherapy codes, psychotherapy with E/M add-on codes, and group psychotherapy codes.

6. How are ICD-10 codes used in mental health billing?

ICD-10-CM codes explain why the patient was treated. CPT or HCPCS codes explain what service was provided. For example, F41.1 may support treatment for generalized anxiety disorder, while 90834 may describe a 45-minute psychotherapy session. CMS states that the submitted medical record must support the selected ICD-10-CM code or codes.

Simplify Mental Health Coding and Billing With Vozo

Mental health billing becomes harder when diagnosis codes, clinical notes, CPT codes, treatment plans, and claim review are handled in disconnected workflows.

Vozo helps behavioral health practices keep documentation, coding, scheduling, telehealth, patient records, and billing workflows connected in one EHR system. Providers can document care more clearly, billing teams can review claims with better context, and practices can reduce avoidable coding gaps before claims go out.

Whether your team manages therapy visits, psychiatric evaluations, medication follow-ups, group sessions, or ongoing behavioral health care, Vozo helps bring clinical and billing workflows into one organized system.