Wiki Psychotherapy codes w/new Telemedicine Synchronous Audio-Video E/M codes for 2025

[juliedogra86]

In 2024 and previously at our psychiatric office for medication management and therapy, our providers, all MDs and NPs, would code a typical 30 minute visit as 99214, 90833 for an E/M with the psychotherapy add on. Whenever this was completed by a video we would also add the telemedicine 95 modifier to each code. However, even though Mediciare is not using them, our Commercial payers, like BCBSIL has now implemented the new CPT 2025 Synchronous Audio-Visual E/M codes (98000-98007) for visits. I do not see written language in the 2025 CPT book about using the Psychotherapy add on codes for these new Telehealth E/M codes specifically so i was wondering if any other practices have run into issues yet with submitting claims with 98006, 90833-95 for example for an established 30 minute telehealth visit?

 

[dogwhisperer36]

I just came here to ask the same question! I used the Codify Claim Scrubber tool and entered 98007 and 90838 and it looks like the 98007 is not listed as a parent code for the 90838. I'm wondering if we can bill the 90837 with a 25 on the 98007 instead? I'm not sure how else to bill these. I'm trying to find a way to contact the AMA because I am hoping that this is just an oversite.....

 

[juliedogra86]

I agree with you, and I came to the same conclusion that if commercial payers are using the new Telemedicine E/M codes, but the CPT code list didn't add the Psychotherapy add on codes for E/M then the only option is to use the stand alone therapy code with the 98007. I will try submitting claims this way until I get a denial.i would be VERY interested if you do hear back from AMA on this ruling/oversight. 90833, 90836 and 90838 are supposed to be linked to E/M codes and 98000-98007 are E/M codes, so it doesn't make sense why they were not linked.

 

[SuFra21]

Glad I'm not the only trying to figure this out! I have BH and Nutrition providers that both do virtual visits and it seems like the new codes are more like the E/M level of service codes for medical office visits. It seems silly to code for the specialty visit and charge for the telehealth visit on top of that in my opinion.

 

[dogwhisperer36]

I tried calling the AMA. They said that I can create an account and submit a coding inquiry; however, they charge $250 per "investigation". Ouch!

Not sure where to go from here. I tried both Aetna's coding tool and Codify and they are showing that it would be correct coding to bill the 90837, 90834, or 90832 with the new codes (98001 - 98007), but not the 90838, 90836, or 90833.

 

[juliedogra86]

Glad I'm not the only trying to figure this out! I have BH and Nutrition providers that both do virtual visits and it seems like the new codes are more like the E/M level of service codes for medical office visits. It seems silly to code for the specialty visit and charge for the telehealth visit on top of that in my opinion.

What codes did you use in 2024 for the BH and Nutrition encounters? Did you use the E/M codes 99202-99215? The new codes for telemedicine (98000-98007) replace 99202-99215 when the encounter was completed by video telemedicine. So if you coded 99213 plus an add on BH/Nutrition code in 2024 I THINK you would now code 98005 with the BH/Nutrition add on codes. But if you have stand alone BH/Nutrition codes and were NOT using 99202-99215 with modifier 95 for telehealth, then I'm not sure.

 

[SuFra21]

What codes did you use in 2024 for the BH and Nutrition encounters? Did you use the E/M codes 99202-99215? The new codes for telemedicine (98000-98007) replace 99202-99215 when the encounter was completed by video telemedicine. So if you coded 99213 plus an add on BH/Nutrition code in 2024 I THINK you would now code 98005 with the BH/Nutrition add on codes. But if you have stand alone BH/Nutrition codes and were NOT using 99202-99215 with modifier 95 for telehealth, then I'm not sure.

For BH we used psychotherapy by time codes and nutrition used the MNT codes. When they had virtual visits we would append the modifier onto the claim. I think we still should but I'm second guessing myself!

 

[juliedogra86]

For BH we used psychotherapy by time codes and nutrition used the MNT codes. When they had virtual visits we would append the modifier onto the claim. I think we still should but I'm second guessing myself!

I'm at a loss as well and still waiting for my first claims of 2025 to process. In 2024 for BCBSIL we would code POS: 10, 99214-95, 90833-95 based on time for telemedicine (30 minutes). However the new telemedicine audio-visual E/M code 98006 cannot be linked with the psychotherapy add-on code 90833, I get an error like it doesn't recognize that 98006 is E/M and 90833 is an E/M add on code? Which doesn't make any sense as 90833 for face-to-face visits DOES still link with 99214 in the 2025 CPT book. I think it's an oversight/error. Until the Medicare deadline ends on April 1 our practice has decided to continue coding to our commercial payers as we did in 2024 and not use the new audio-video E/M codes until this is figured out as we are unable to code correctly with our psychotherapy add ons (90833, 90836, 90838) for telemedicine.

 

[juliedogra86]

I agree with you, and I came to the same conclusion that if commercial payers are using the new Telemedicine E/M codes, but the CPT code list didn't add the Psychotherapy add on codes for E/M then the only option is to use the stand alone therapy code with the 98007. I will try submitting claims this way until I get a denial.i would be VERY interested if you do hear back from AMA on this ruling/oversight. 90833, 90836 and 90838 are supposed to be linked to E/M codes and 98000-98007 are E/M codes, so it doesn't make sense why they were not linked.

Just an update as with my other response. Our practice decided to stop using the new audio-visual E/M codes (98000-98007) completely as our scrubbing tool (Relay Exchange) wasn't recongzing them either and saying we needed to still add the 95 modifier, which is ALSO incorrect as the CPT book notes the 95 modifier is not required. So for now we're sticking with 99214-95, 90833-95 until this is resolved or we have denials on our claims.

 

[jdd111168]

I know many are continuing to use the Office visit E&M codes with modifier 95 and the add-on psychotherapy code.

However, if we follow the rule that we should report the code(s) that best describe the service(s) rendered the new Telemedicine codes best describe an audio-video E&M encounter. The Psychotherapy add-on codes 90833, 90836 and 90838 have a parenthetical instruction that states that they are add-on codes and must be reported in conjunction with 99202-99255, 99304-99337, 99341-99350. In the CPT book our new E&M codes 98000-98016 fall in the range of codes 99202-99255.

Per the 2025 Complete Table of Contents Medicare NCCI Coding Policy (link below) on pg. 22 (or I-6) the fourth paragraph states, “In 2010, the CPT Professional codebook modified the numbering of codes so that the sequence of codes as they appear in the CPT Professional codebook does not necessarily correspond to a sequential numbering of codes. In the Medicare NCCI Policy Manual, use of a numerical range of codes reflects all codes that numerically fall within the range regardless of their sequential order in the CPT Professional codebook.” https://www.cms.gov/files/document/2025nccimedicarepolicymanualcompletepdf.pdf

MY QUESTION - Does this support the use of the Telemedicine E&M codes with the add-on Psychotherapy codes because the Telemedicine E&M codes fall in the E&M code range? What do you think?

 

[Cynthia Hughes]

I know many are continuing to use the Office visit E&M codes with modifier 95 and the add-on psychotherapy code.

However, if we follow the rule that we should report the code(s) that best describe the service(s) rendered the new Telemedicine codes best describe an audio-video E&M encounter. The Psychotherapy add-on codes 90833, 90836 and 90838 have a parenthetical instruction that states that they are add-on codes and must be reported in conjunction with 99202-99255, 99304-99337, 99341-99350. In the CPT book our new E&M codes 98000-98016 fall in the range of codes 99202-99255.

Per the 2025 Complete Table of Contents Medicare NCCI Coding Policy (link below) on pg. 22 (or I-6) the fourth paragraph states, “In 2010, the CPT Professional codebook modified the numbering of codes so that the sequence of codes as they appear in the CPT Professional codebook does not necessarily correspond to a sequential numbering of codes. In the Medicare NCCI Policy Manual, use of a numerical range of codes reflects all codes that numerically fall within the range regardless of their sequential order in the CPT Professional codebook.” https://www.cms.gov/files/document/2025nccimedicarepolicymanualcompletepdf.pdf

MY QUESTION - Does this support the use of the Telemedicine E&M codes with the add-on Psychotherapy codes because the Telemedicine E&M codes fall in the E&M code range? What do you think?

You do have a point that the telemedicine codes are placed in the range between 99202-99255 and the parenthetical remark below the psychotherapy when performed with E/M includes that range of codes. I think that supports use of the telemedicine E/M codes in conjunction with the psychotherapy codes. Hopefully, payers will see this the same way. Cindy

 

[natashalage]

Every good find Jdd111168! Psych specialty is new to me and I am still studying, collecting any information I can find. And with this new changes and every year additional codes, coding drives me crazy. I ask myself “when AMA will stop creating new e/m cpt and instead, make our life easier and more clear?” AAPC is offering psych webinar for $65, I will attend ( have my own questions to ask but if tele cpt will be discussed, then I share the response here. The webinar is on 29th.

 

[juliedogra86]

Every good find Jdd111168! Psych specialty is new to me and I am still studying, collecting any information I can find. And with this new changes and every year additional codes, coding drives me crazy. I ask myself “when AMA will stop creating new e/m cpt and instead, make our life easier and more clear?” AAPC is offering psych webinar for $65, I will attend ( have my own questions to ask but if tele cpt will be discussed, then I share the response here. The webinar is on 29th.

I attended the Behavioral Health and Psychiatry webinar today. No new information on the telemedicine codes 98000-98015 was discussed during the webinar, only briefly answered in the Q&A section. Not that helpful really. But all that is to say there is currently NO GUIDANCE to use the 98000-98015 with the Psychotherapy add on codes 90833, 90836, 90838. So for now we have to continue to use 99203-99215 with modifier 95 or 93 when adding 90833, 90836, 90838 for psychotherapy add ons until CMS changes their coding practices. Commercial payers like BCBS, which is my practice's primary payer, are also following Medicare guidelines so we will not use the new telemedicine 98000-98015 codes at all for now when adding psychotherapy.

 

[Brenda1973]

I attended the Behavioral Health and Psychiatry webinar today. No new information on the telemedicine codes 98000-98015 was discussed during the webinar, only briefly answered in the Q&A section. Not that helpful really. But all that is to say there is currently NO GUIDANCE to use the 98000-98015 with the Psychotherapy add on codes 90833, 90836, 90838. So for now we have to continue to use 99203-99215 with modifier 95 or 93 when adding 90833, 90836, 90838 for psychotherapy add ons until CMS changes their coding practices. Commercial payers like BCBS, which is my practice's primary payer, are also following Medicare guidelines so we will not use the new telemedicine 98000-98015 codes at all for now when adding psychotherapy.

Yes I agree with Juliedogra86. I code BH and nothing has changed yet. I use the same codes as last year. I use the new codes for Medical and the same old codes for BH.

 

[irenapetko]

I wonder if anyone can help me. We are billing for BH medication management, and these visits are billed with 99212-99215, but according to the new codes we should be billing 98004-98807 if it is audio-video encounter and 98012-98015 if audio only. We have received a denial for audio only visit 98014, billed with POS 2 and BCBS of NJ denied as non-covered service. How would you bill this claim when we are no longer using 99441-99443?
I cannot bill audio only telehealth claims with old cpt code or 99212-99215 and add a modifier. Can anyone please chime in, if they experienced anything like that?

 

[Brenda1973]

I wonder if anyone can help me. We are billing for BH medication management, and these visits are billed with 99212-99215, but according to the new codes we should be billing 98004-98807 if it is audio-video encounter and 98012-98015 if audio only. We have received a denial for audio only visit 98014, billed with POS 2 and BCBS of NJ denied as non-covered service. How would you bill this claim when we are no longer using 99441-99443?
I cannot bill audio only telehealth claims with old cpt code or 99212-99215 and add a modifier. Can anyone please chime in, if they experienced anything like that?

Behavioral Health codes did not change as of yet. Yes, Medical office codes changed but Behavioral Health is still using the 99212-99215. Please read the post above from juliedogra86 .I attended many seminars on this topic also and Behavioral Health has not changed as of yet and I am not sure if/when it will.
With that said would you be able to help me by sharing your "medication management "note template that your providers use? This is for my education as my providers are documenting more than they actually need to and I would like to help them with a template. If you could that would be greatly appreciated! if you don't want to share on this thread my email address is 245charchar@gmail.com , thank you!

​

 

[juliedogra86]

I wonder if anyone can help me. We are billing for BH medication management, and these visits are billed with 99212-99215, but according to the new codes we should be billing 98004-98807 if it is audio-video encounter and 98012-98015 if audio only. We have received a denial for audio only visit 98014, billed with POS 2 and BCBS of NJ denied as non-covered service. How would you bill this claim when we are no longer using 99441-99443?
I cannot bill audio only telehealth claims with old cpt code or 99212-99215 and add a modifier. Can anyone please chime in, if they experienced anything like that?

You may need to keep using the codes you used in 2024. CMS is not recognizing the new telemedicine codes 98000-98015 for medicare so many commercial plans, like BCBSIL are following suit and still reimbursing for 99214-93 with POS 02/10.

 

[irenapetko]

Behavioral Health codes did not change as of yet. Yes, Medical office codes changed but Behavioral Health is still using the 99212-99215. Please read the post above from juliedogra86 .I attended many seminars on this topic also and Behavioral Health has not changed as of yet and I am not sure if/when it will.
With that said would you be able to help me by sharing your "medication management "note template that your providers use? This is for my education as my providers are documenting more than they actually need to and I would like to help them with a template. If you could that would be greatly appreciated! if you don't want to share on this thread my email address is 245charchar@gmail.com , thank you!

​

I am aware of the fact that BH therapy cpt codes did not change but for meds management we are billing office levels 99212-99215. So, you are saying that I should be still using these CPT codes with modifiers and updated POS? And what about audio only codes? CPT code 99441 was a code used for telephone evaluation and management (E/M) services for established patients, which now should be replaced with 98012-98015. I am wrong?
Also, the template- please check your email

 

[Brenda1973]

I am aware of the fact that BH therapy cpt codes did not change but for meds management we are billing office levels 99212-99215. So, you are saying that I should be still using these CPT codes with modifiers and updated POS? And what about audio only codes? CPT code 99441 was a code used for telephone evaluation and management (E/M) services for established patients, which now should be replaced with 98012-98015. I am wrong?
Also, the template- please check your email

Thank you much for template! Yes I see your concern now and understand where you are coming from with the medication management 99212-99215. At our facility we were advised to not change those, to use the EM level as usual with modifier and POS and I believe the reason we are not getting rejections is connected to the Behavioral Health NPI number and provider ID numbers all falling under Behavioral Health. I have never have used the 99441 for behavioral health, I only used that code on medical. Sorry I may not be much help but that is how it is working out at my facility at the moment. Its definitely difficult with all of the changes happening. Please feel free to share any new information that arises and I will also.

 

[sunndropp@gmail.com]

Hello! I'm new to billing ( started Nov of 2024) and currently billing for Behavioral Health. Is it possible to bill for 1 1/2 hours sessions? I have the 2025 CPT manual, but can't seem to find the info. I generally bill 90837 or 90791. Any input would be greatly appreciated! Thank you

 

[lauriebernadette]

I agree with you, and I came to the same conclusion that if commercial payers are using the new Telemedicine E/M codes, but the CPT code list didn't add the Psychotherapy add on codes for E/M then the only option is to use the stand alone therapy code with the 98007. I will try submitting claims this way until I get a denial.i would be VERY interested if you do hear back from AMA on this ruling/oversight. 90833, 90836 and 90838 are supposed to be linked to E/M codes and 98000-98007 are E/M codes, so it doesn't make sense why they were not linked.

Hello! I am just wondering if you have any updates on if you got any denials on billing the stand-alone psych code with the new telehealth code? Or if you have any updates on this topic. Thank you!

 

[brajt]

We are getting a lot of denials, especially from the Blues that are NOT recognizing the 98000-98015 series with the BHS add on codes. They are remitting to us with B15 - Qualifying other procedure/service not received/adjudicated. They are paying the 98006 but not the 90833, 90836. At the end of January I believe we got notification on the codes 98000-98015 codes that they will recognize them 7/1/25 and we can use either/or the old codes until that date. My concern is that the new telehealth E&M codes are not recognized as the parent code for BHS. Anyone else having this issue?