2025 Coding and Payment Guide for Behavioral Health Services (Spiral)
Optum | 2025 |
The Coding and Payment Guide for Behavioral Health Services is your one-stop coding, reimbursement, and documentation resource developed exclusively for behavioral health. This comprehensive and easy-to-use guide is updated for 2025 and organized by specialty-specific CPT® codes. Each CPT® code includes its official description and lay description, coding tip, Medicare edits, and relative value units and is cross-coded to common ICD-10-CM diagnosis codes to complete the coding process. Getting to the code information you need has never been so easy.
- Evaluation and Management (E/M) Services Guidelines – E/M codes are used every day in your practice. With CPT® E/M Guidelines and our Optum Coding Tips, you have all the information you need to select the correct E/M code for the service provided.
- Procedure code icons. Quickly identify new, revised, add-on, and telemedicine procedure codes, making your coding process for procedures and E/M services quick and efficient.
- ICD-10-CM code icons. Icons identify male and female only codes, as well as age-related diagnosis codes.
- Easily determine fees for your practice and reinforce consistency in the charges. Relative value units including the practice, work, and malpractice components with the total RVUs for non-facility and facility also included.
- Quickly find information. All the information you need is provided, including CPT® full code descriptions, lay descriptions, coding tips, procedure code-specific documentation and reimbursement tips, post op or follow up days, Medicare edits including IOM references and Medicare Unlikely Edits designations (MUE), and commonly associated ICD-10-CM diagnosis codes.
- CPT® Assistant references. Identify that an article or discussion of the CPT® code has been in the American Medical Association’s CPT® Assistant newsletter. Use the citation to locate the correct volume.
- CCI edits by CPT® and HCPCS procedure code. CPT® and HCPCS procedure codes with their associated CCI edits are provided in a special section. Quarterly updates, and other significant updates, are available online at Optumcoding.com Product Update page.
Tara Rose, CPC-I, CPMA, RHIA, CCS-P, AHIMA- approved ICD-10-CM/PCS Trainer
Ms. Rose has more than 15 years of experience in the healthcare profession. She has extensive experience in auditing, teaching, physician billing, and multi-specialty coding with experience in coding CPT, HCPCS, and ICD-10-CM. Most recently Ms. Rose was a post payment auditor and coding consultant. She also taught coding to physicians and at a local community college. Ms. Rose has been a member of her local American Academy of Professional Coders (AAPC) chapter and the American Health Information Management Association (AHIMA) for many years.
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