Telehealth CPT Codes 2025: Understanding for 2025 and Beyond

Telehealth has gained popularity as a method for mental health professionals to deliver care, especially following the COVID-19 pandemic. As technology advances and regulations change, therapists need to stay updated on the latest in telehealth billing and coding practices.

To bill successfully for telehealth, therapists must understand the Current Procedural Terminology (CPT) codes specific to remote care. These codes ensure accurate reimbursement and compliance with healthcare regulations.

This article focuses on telehealth CPT codes, examining their role in the billing process and discussing recent changes in telehealth regulations. You’ll gain insight into navigating the complexities of telehealth coding and billing in 2025 and beyond.

Introduction to Telehealth and CPT Codes

Telehealth involves delivering healthcare services remotely using electronic communication technologies like video conferencing, phone calls, or secure messaging. CPT codes play a crucial role in accurately documenting and billing these services, ensuring mental health professionals receive proper reimbursement for their work.

In recent years, significant changes in telehealth regulations, driven by the increased use of remote care during the COVID-19 pandemic, have affected how mental health professionals deliver care, bill for services, and maintain compliance with healthcare regulations.

Telehealth CPT Codes: Current Landscape and Changes

The updates for telehealth CPT codes in 2025 introduce important changes to improve the billing and coding process for remote care services. Key updates include:

• New CPT Codes: The AMA has added 17 new CPT codes for telehealth services, covering both audio-visual and audio-only E/M visits and virtual check-ins.
• Extended Medicare Flexibilities: . A new appropriations package, passed on March 14, 2025, includes an extension of telehealth flexibilities that removes geographic restrictions and expands originating sites until Sept. 30, 2025.
• Expanded Practitioner Eligibility: More practitioners can now provide telehealth services, increasing access to remote care.

The new CPT codes for audio-visual and audio-only visits are divided into categories for new and established patients, with codes based on medical decision-making (MDM) complexity or time spent:

• New Patient Audio-Visual Codes: 98000 (straightforward MDM or 15 min), 98001 (low MDM or 30 min), 98002 (moderate MDM or 45 min), 98003 (high MDM or 60 min).
• New Patient Audio-Only Codes: 98008 (straightforward MDM or 15 min), 98009 (low MDM or 30 min), 98010 (moderate MDM or 45 min), 98011 (high MDM or 60 min).
• Established Patient Audio-Visual Codes: 98004 (straightforward MDM or 15 min), 98005 (low MDM or 30 min), 98006 (moderate MDM or 45 min), 98007 (high MDM or 60 min).
• Established Patient Audio-Only Codes: 98012 (straightforward MDM or 15 min), 98013 (low MDM or 30 min), 98014 (moderate MDM or 45 min), 98015 (high MDM or 60 min).

Additionally, code +99417 can be used as an add-on for prolonged services lasting 75 minutes or more, while code 98016 is used for brief virtual check-ins (5–10 minutes).

It's important to note that CMS has specific reporting requirements, such as using in-person E/M codes with modifiers 95 (audio-video) or 93 (audio-only) and the appropriate place of service codes (02 for telehealth not in the patient's home, 10 for services in the patient's home).

Understanding Different Telehealth Code Categories

Telehealth CPT codes are split into various categories based on the type of service provided and how it is delivered. Knowing these categories is important for accurate billing and reimbursement. The two main types of telehealth services are synchronous and asynchronous.

Synchronous telehealth involves real-time, interactive communication between patients and healthcare providers, usually via video or audio conferencing. This setup allows for immediate discussion of patient concerns, remote examinations, and real-time care planning. Synchronous telehealth CPT codes for mental health services include:

• Psychiatric diagnostic evaluations (90791, 90792)
• Psychotherapy (90832, 90834, 90837)
• Crisis psychotherapy (90839, 90840)
• Group psychotherapy (90853)
• Family psychotherapy (90846, 90847)
• Medication management (99211-99215)

Asynchronous telehealth, also known as "store-and-forward," involves collecting medical data and transmitting it to healthcare providers for review at a later time. This approach works well for specialties requiring image or video sharing, such as telepsychiatry consultations. Asynchronous telehealth CPT codes for mental health services include:

• Online digital evaluation and management services (99421-99423)
• Remote patient monitoring (99453, 99454, 99457, 99458)
• Interprofessional telephone/internet/electronic health record consultations (99446-99449, 99451, 99452)

Both synchronous and asynchronous telehealth services work best when used together, as they address different aspects of patient care and provider needs. Mental health professionals should get familiar with the appropriate CPT codes for each type of service to ensure accurate billing and compliance with healthcare regulations.

How Telehealth CPT Codes Affect Mental Health Practices

The growth of telehealth services has changed how mental health professionals deliver care and bill for their services. With new CPT codes and updated regulations, therapists need to adjust their billing practices to ensure proper reimbursement and compliance.

When billing for individual therapy sessions, mental health providers use the following CPT codes:

• 90832, 90834, 90837: Psychotherapy sessions lasting 30, 45, and 60 minutes, respectively.
• 90791, 90792: Psychiatric diagnostic evaluations.

For group therapy sessions, providers use CPT code 90853, while family psychotherapy sessions, with or without the patient present, use codes 90846 and 90847, respectively.

Therapists must use the appropriate modifiers to show that services were provided via telehealth:

• Modifier 95: Real-time audio and video telemedicine services.
• Modifier FQ: Audio-only telehealth services.

The Place of Service (POS) codes are important for accurate billing:

• POS 02: Telehealth services when the patient is not at home.
• POS 10: Services provided to a patient at their home.

Reimbursement rates for telehealth services often match those for in-person services, thanks to parity laws. However, therapists need to confirm each payer's specific requirements for codes, modifiers, and documentation to ensure timely reimbursement.

Remote patient monitoring (RPM) has gained popularity in mental health care, allowing therapists to track patient progress between sessions. CPT codes 99453, 99454, 99457, and 99458 apply to RPM services, enabling therapists to bill for time spent reviewing and interpreting patient-generated health data.

As telehealth regulations continue to change, mental health professionals must stay updated on CPT codes and billing practices. Regularly reviewing payer policies and consulting professional organizations can help therapists manage the complexities of telehealth billing and ensure compliance with state and federal regulations.

Navigating Telehealth Compliance and Legal Issues

As telehealth becomes a regular part of mental health care, therapists must understand and manage the complex issues of compliance and legal requirements. Ignoring these regulations can lead to penalties, loss of reimbursement, and even legal trouble.

A major aspect of telehealth compliance involves meeting the standards set by the Health Insurance Portability and Accountability Act (HIPAA). This means using secure, encrypted platforms for video conferencing and messaging, along with maintaining proper documentation and patient privacy practices. Therapists should thoroughly evaluate their telehealth platforms and tools to ensure they meet HIPAA guidelines.

Besides federal regulations, mental health professionals need to comply with state-specific telehealth laws and insurance requirements. These can vary significantly, so staying informed about the regulations in your state and any states where you offer services is important. Key areas to focus on include:

• Licensure requirements: Many states mandate that therapists hold a license in the state where the client is located during the telehealth session. Some states participate in the Counseling Compact, which allows licensed counselors to practice across state lines. Always verify the requirements for your state and the client’s state before providing treatment.  
• Informed consent: Therapists must secure informed consent from patients before starting telehealth services, which might require extra documentation.
• Insurance mandates: Some states have specific rules for insurance coverage of telehealth services, including payment parity laws.

Ethical considerations are also very important in telehealth mental health care. Therapists must ensure they provide the same quality of care as they would in person and determine if telehealth suits each patient's needs. This may involve assessing patients for suitability, discussing the limitations and risks of telehealth, and having a plan ready for emergencies or technical issues.

To maintain privacy and security in virtual care, therapists should follow these best practices:

• Using secure, encrypted platforms for all telehealth communications.
• Conducting sessions in a private, confidential space with minimal distractions.
• Regularly updating software and security protocols to guard against data breaches.
• Educating patients on the importance of privacy and security in telehealth.

As telehealth regulations continue to change, mental health professionals must keep up-to-date and adjust their practices accordingly. Regularly reviewing guidance from professional organizations, state licensing boards, and insurance providers can help therapists manage the complexities of telehealth compliance and ensure they provide the best care to their patients.

Reimbursement Trends and Payment Policies

As telehealth continues to play a significant role in mental health care delivery, keeping up with reimbursement trends and payment policies is important for therapists. In 2025, we notice ongoing developments in Medicare, Medicaid, and private insurance policies related to telehealth services.

Medicare has extended its telehealth flexibilities through September 2025.3. This allows mental health professionals to continue providing and billing for telehealth services to Medicare beneficiaries, with fewer restrictions on originating sites and eligible practitioners. However, Congress must act to make these changes permanent. At this time, uncertainty surrounding the long-term availability of telehealth services remains a significant concern.

Medicaid reimbursement for telehealth services varies by state, with many states expanding coverage in targeted areas. Key trends in Medicaid telehealth reimbursement include:

• Modality Coverage: Most state Medicaid programs now reimburse for live video, store-and-forward, and remote patient monitoring (RPM) services, though limitations may apply.
• Cross-State Licensing: Some states have expanded cross-state licensing allowances to improve access to telehealth services.

Private insurance companies are also adjusting their telehealth reimbursement policies. As of 2025, 44 states and the District of Columbia have laws addressing telehealth reimbursement for private payers, with many requiring payment parity between telehealth and in-person services.

Looking ahead, industry experts predict that telehealth reimbursement rates will continue to change as more data on the effectiveness and cost-efficiency of remote care becomes available. Advocacy groups are pushing for permanent telehealth reimbursement policies, arguing that they improve access to care and patient outcomes.

As a mental health professional, staying informed about the latest developments in telehealth reimbursement is key to maintaining a successful practice. Regularly review guidance from professional organizations, state licensing boards, and insurance providers to ensure you are billing correctly and getting the most out of your reimbursement.

Case Examples and Scenarios

To better understand how to apply telehealth CPT codes in everyday situations, let's explore a few case examples that illustrate common coding challenges and ways to handle tricky billing scenarios.

• Case 1: Audio-only therapy session
• A therapist conducts a 45-minute psychotherapy session with an established patient using only audio communication due to the patient's lack of access to video technology.
• The suitable CPT code for this situation is 90834, which represents audio-only standalone psychotherapy for 45 minutes.
• The therapist should also use modifier FQ or modified 93 to show that the service was provided via audio-only communication.
• Case 2: Remote patient monitoring for anxiety
• A mental health professional uses remote patient monitoring (RPM) to track symptoms and progress between sessions for patients with anxiety disorders.
• The practice can bill for RPM services using CPT codes 99453 (initial setup and patient education), 99454 (device supply and daily recordings), and 99457 (remote physiologic monitoring treatment management services, first 20 minutes).
• This can only be billed if working under a physician (MD/DO) or QHP (NP/PA) and must be billed by the supervising provider.
• If more time is spent reviewing and interpreting patient-generated health data, the practice can use code 99458 for each additional 20 minutes.
• Case 3: Group therapy via video conferencing
• A therapist leads a 60-minute group therapy session with 8 patients using a secure video conferencing platform.
• The appropriate CPT code for this scenario is 90853, which represents group psychotherapy.
• The therapist should use modifier 95 to indicate that the service was provided via real-time audio and video communication.
• The Place of Service (POS) code 02 is used if the patients are not at home during the session, or POS 10 if they are at home.

When dealing with challenging cases involving telehealth billing, it's important to:

1. Carefully review payer policies and requirements for telehealth services. Verify policies and requirements for each payer you work with, as coverage may vary.
2. Ensure proper documentation of the service provided, including start and end times, communication method, and patient location.
3. Seek advice from colleagues or professional organizations for guidance on complex billing scenarios.
4. Keep up-to-date with changes to telehealth regulations and CPT codes to ensure compliance and accurate billing.

Familiarizing yourself with common case examples and strategies for handling challenging billing situations helps to streamline your telehealth billing process and ensure proper reimbursement for the valuable services you provide.

Conclusion: Staying Ahead with Telehealth Coding

As telehealth continues to change the landscape of mental health care, therapists must focus on staying updated on CPT code changes to ensure accurate billing and compliance. Here are some tips for keeping up with the ever-evolving landscape of telehealth coding:

• Regularly review updates from professional organizations: Organizations like the American Psychological Association (APA) and the American Medical Association (AMA) provide timely information on CPT code changes and telehealth billing practices.
• Attend webinars and workshops: Many professional organizations and healthcare technology companies offer webinars and workshops focused on telehealth coding and billing. These sessions provide valuable insights and practical strategies for managing the complexities of telehealth reimbursement.
• Use online resources: Websites like the Centers for Medicare & Medicaid Services (CMS) and the National Telehealth Policy Resource Center offer comprehensive guides, fact sheets, and FAQs on telehealth coding and reimbursement.
• Collaborate with colleagues: Engaging in discussions with colleagues and joining professional networks can help you stay informed about best practices and emerging trends in telehealth coding.

Ongoing education plays an important role in ensuring you are equipped to handle the changing landscape of telehealth coding. Therapists should focus on learning opportunities that cover:

1. Understanding new and revised CPT codes: Keeping up-to-date on the latest CPT code additions and modifications is key for accurate billing and reimbursement.
2. Mastering telehealth documentation requirements: Proper documentation is vital for justifying the use of telehealth CPT codes and ensuring compliance with healthcare regulations.
3. Navigating state-specific telehealth laws and policies: As telehealth regulations vary by state, therapists must stay informed about the specific requirements in the states where they practice.
4. Adapting to changes in payer policies: Continuously monitoring updates to Medicare, Medicaid, and private insurance telehealth reimbursement policies is important for maintaining a successful practice.

Investing time and effort in ongoing education enables you to confidently face the future of telehealth and provide the best possible care to your patients.