If you’re in mental health, you already know billing can feel like its own full-time job. Claims bounce back, insurers move the goalposts, and one wrong code can put a hold on your payments. It’s frustrating. But the truth is, staying on top of CPT codes makes all the difference between smooth reimbursement and endless back and forth with insurance companies.
For 2025, there are some updates you’ll want to pay attention to, especially if you’re doing a lot of Telehealth. Let’s break it down in plain language so you know what’s staying the same, what’s changing, and how to keep your billing clean this year.
Why CPT Codes Are Such a Big Deal in Mental Health
In surgery, it’s easy to bill— “appendix removed” is clear. In mental health it’s less visible. A therapy session or a diagnostic evaluation doesn’t come with an X-ray image or lab test as proof. CPT codes are the way we explain our work to insurers.
Think of them as the shorthand for the story of each session: how long it lasted, whether meds were managed, whether it was in person or over video. Without the right code, your story gets lost, and your claim gets denied.
Core Mental Health Codes You’ll Still Use in 2025
These haven’t changed, but they’re the bread and butter of mental health billing:
Psychotherapy
- 90832 – Individual therapy, 30 minutes
- 90834 – Individual therapy, 45 minutes
- 90837 – Individual therapy, 60 minutes
- 90846 – Family therapy without patient present
- 90847 – Family therapy with patient present
Example: If you usually run 45-minute Zoom sessions, 90834 is the one you’ll bill most often. If you go the full hour, that’s when 90837 applies.
Diagnostic Evaluations
- 90791 – Psychiatric diagnostic evaluation, no medical services
- 90792 – Diagnostic evaluation with medical services
Example: Think first time patient intake. If you’re only doing the assessment, use 90791. If you’re also reviewing labs or considering medication, that’s 90792.
Medication Management
- 90863 – Pharmacologic management, add-on to psychotherapy
Example: Let’s say you’re a psychiatrist. You spend 45 minutes in therapy (90834) and also adjust their meds. That’s when you add 90863.
Telehealth in 2025: The Big Shift
Here’s where things get interesting. Telehealth exploded during the pandemic and now payors are finally catching up with new codes. The old telephone visit codes (99441–99443) are gone. deleted. If you bill them this year, expect denials.
They’ve been replaced by the new 98000–98016 code range.
Synchronous Audio-Video E/M Services – New Patient
| Code | Description |
|---|---|
| 98000 | Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded. |
| 98001 | Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded. |
| 98002 | Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded. |
| 98003 | Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded. |
Synchronous Audio-Video E/M Services – Established Patient
| Code | Description |
|---|---|
| 98004 | Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 10 minutes must be met or exceeded. |
| 98005 | Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded. |
| 98006 | Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded. |
| 98007 | Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded. |
Synchronous Audio-Only E/M Services – New Patient
| Code | Description |
|---|---|
| 98008 | Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded. |
| 98009 | Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded. |
| 98010 | Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded. |
| 98011 | Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded. |
Synchronous Audio-Only E/M Services – Established Patient Code
| Code | Description |
|---|---|
| 98012 | Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 10 minutes must be met or exceeded. |
| 98013 | Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded. |
| 98014 | Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded. |
| 98015 | Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded. |
Brief Synchronous Communication Technology Service (e.g., Virtual Check-In)
| Code | Description |
|---|---|
| 98016 | Brief communication technology-based service (e.g., virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation and management service provided within the previous 7 days nor leading to an evaluation and management service or procedure within the next 24 hours or soonest available appointment, 5–10 minutes of medical discussion. |
Example: If you’re doing a 30-minute video session with a brand new client, you’ll use one of the 98000 series codes instead of a therapy code. But if you’re doing ongoing therapy, you still stick with the psychotherapy codes—just add the telehealth modifier if your payer requires it.
Example: If a long-time client can’t get on video and you do a phone session instead, you’d pull from the 98012–98015 range.
Psychological Testing and Assessment
Testing services can be tricky, but the codes haven’t changed much this year:
- 96130–96131: Psychological testing evaluation
- 96136–96139: Test administration and scoring
- 96146: Automated testing via electronic platform
Example: If you’re running a personality inventory through an online system, 96146 is your code. If you’re sitting with the patient for several hours of neuropsychic testing, you’ll be billing time with 96130/96131.
Tips for Smoother Billing in 2025
- Update your cheat sheet. Print or save a quick list of your most-used codes and replace any that were deleted.
- Document as if you’ll be audited. Insurers are quick to flag high-frequency codes like Notes that clearly show medical necessity protect you.
- Know your payer’s telehealth rules. Some still pay differently for audio-only versus video. Don’t assume.
- Use add-ons when appropriate. If you’re providing therapy and med management in the same session, add 90863.
- Check your top codes once a quarter. A quick self-audit can help you catch errors before the insurance company does.
Final Thoughts
Billing may never be the most exciting part of our work, but it’s what keeps the doors open. For 2025, the biggest shifts are around telehealth. Learn the new 98000-series codes, stop using the old phone codes, and keep your documentation tight.
The sooner you get comfortable with these changes, the less time you’ll spend arguing with insurers—and the more time you can spend with your patients, which is what really matters.
