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

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?

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.....

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.

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.

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.

SuFra21 said:

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.

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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.