2026 Coding and Payment Guide for Behavioral Health Services (Spiral)
Optum | 2026 |
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 2026 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 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.
- Product Updates. Significant updates to this guide and CCI edit updates, will be made available on the Optum Product Update page on Optumcoding.com for our valued Coding and Payment Guide customers.
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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