Today, people are more aware about their overall health including thoughts, emotions and behavior. Because of this, there is a rise in the number of individuals who seek medical aid for behavioral health. Now, the increase in patients is directly related to behavioral health billing, administrative burden and its effect on patient care.
Handling a multitude of patients and maintaining revenue cycle management is a challenging task. So, if you find yourself in a similar situation, it is a sign that your billing process needs a change. It is crucial to find a solution to administrative issues and lead your practice to maximum revenue.
In 2025, it’s time to change your approach towards behavioral health billing and achieve a better financial posture. Let’s learn about important updates, common challenges and how you can solve them!
Top Behavioral Health Billing Updates You need to Know in 2025
Staying current with frequent administrative changes is the key to achieving success in your billing process. It is your conscious step towards reducing errors and preventing denials.
In terms of behavioral health billing, there are updates in ICD-10-CM codes, CPT codes and Telehealth Billing.
Let’s see them one by one:
Revisions in ICD-10-CM Codes
In 2025, there is an introduction of new codes, updates in definitions and specificity enhancement for behavioral health diagnostics.
Newly Introduced Codes:
- F32.A – A mild single episode of major depressive disorder accompanied by symptoms of anxious distress.
- F43.8A – Prolonged grief disorder, reflecting focus on conditions that have historically received less clinical attention.
Updated Definition of F41.1: Generalized anxiety disorder is now classified into subcategories based on severity levels.
Increased Precision: F43.1 – Post-traumatic stress disorder (PTSD) is now differentiated by acute, chronic, and delayed onset presentations.
Updates in CPT Codes
It is vital to know the new CPT updates to enhance overall coding accuracy.
Updated Psychotherapy Codes:
Codes 90834 (45 minutes) and 90837 (60 minutes) now mandate detailed documentation of the therapeutic methods applied during sessions.
New Digital Behavioral Health Codes:
- 989X1 – Covers the earliest setup and patient education for digital behavioral health devices.
- 989X2 – Applies to ongoing monthly monitoring and clinician feedback related to digital interventions.
Behavioral Health Integration (BHI):
Code 99494 now includes extended descriptions for care management services, emphasizing collaborative and cooperative attestation.
Advancements in Telehealth Reimbursement
Telehealth is a crucial aspect of medical billing and that is why staying up to date with advancements is necessary.
Broadened Reimbursement:
Virtual delivery of family therapy (90846) and group therapy (90853) is now eligible for reimbursement.
Telehealth Modifiers:
- GT – Indicates real-time audio-visual telecommunication.
- 95 – Designates services rendered via telehealth.
Interstate Practice Guidelines:
Billing policies for providing telehealth services across state lines have been clarified.
Healthcare providers must incorporate these changes in their billing process to improve their efficiency and accuracy.
Key Complexities in Behavioral Health Billing
Complexities in medical billing for various medical specialties are more or less the same. In every healthcare practice, ensuring accuracy and efficiency is fundamental. However, before that, it is essential to understand what exactly is causing issues in your healthcare practice.
Once you are aware of your weak points, making improvements becomes easy. Addressing challenges with strategic solutions begins with analyzing everything and then deciding. This way you can streamline the administrative process and help you enhance the quality of patient care.
Let’s dive deeper into the challenges!
Inaccuracies in documentation cause more damage to behavioral medical billing than any other drawback. They are documentational errors that lead to coding oversight further resulting in claim denials. However, why is documentation so important?
Basically, at the time of claim filing, healthcare providers need detailed proof of rendered medical services. Necessary information includes approved medical necessity, treatment method and clinical notes.
Lack of proper time and sufficient training are the prime reason behind issues created by improper documentation.
An ideal solution to improve your documentation process is choosing medical billing services in New York. Experienced companies utilize electronic health record (EHR) systems to streamline the documentation process and achieve positive revenue results.
Obstacles During Prior Authorization
When it comes to behavioral health billing process, focusing on attaining prior authorization is as important. Seeking approval on time is crucial to continue with the treatment process. However, paperwork regarding therapy sessions and psychological assessment is time consuming and prone to drawbacks.
To solve this situation, healthcare providers must appoint a qualified team that can handle everything with precision. Staying ahead of approvals is clearly a task of maintaining accuracy and efficiency.
Higher Number of Denials
Another complexity of behavioral medical billing process is claim denials and their mishandling. Denials may occur due to various reasons, but it is the administration’s responsibility to eliminate the root cause. Without the right denial management process, healthcare practices cannot reduce their revenue leakages.
For this, healthcare providers must follow a meticulous approach towards denials to identify real issues and solve them.
How Medical Billing Services in New York Streamline Your Billing Process?
Behavioral health billing requires a comprehensive approach in which all steps are analyzed and corrected to improve the revenue flow. Medical billing services achieve these goals effortlessly and help healthcare practices maximize revenue.
Here’s how a medical billing company can help take your healthcare practice to the next level:
Solving Coding Complexity
A medical billing company works with qualified coders and utilizes premium technological tools. Together, they simplify the coding process and remove manual errors and enhance overall accuracy.
Fulfilling the Approval Criteria
Professional medical billers are experienced at handling prior authorization process from behavioral health billing. They also have better connections withing insurance provider networks leading to quick response time.
Reducing Documentation Errors
As medical billing services handle the entire administrative process, they reduce documentation errors and also limit missing details. Accurate data leads to higher clean claims rate.
Following Proper Denial Management Process
Medical billing companies understand the impact of denials on behavioral therapy practice. Therefore, they ensure an effective denial management that not just recovers lost revenue but also prevents them in future.
Choose Medical Billing Services in New York
Behavioral health billing has many complexities and if healthcare providers want to maximize revenue, they must improve their process. Medical billing services are one such way that offers expertise, skill and medical billing handling while allowing healthcare providers to focus on patients.
Eminence RCM is a reliable and result-oriented medical billing company in the US. We are experienced at handling behavioral health billing. Our team is proficient at accelerating revenue cycle management, reducing complexities and achieving adequate revenue.
We are also keen about following HIPAA compliance so that your patient’s sensitive information is always protected. Whether it is denial management, prior authorization, coding or submission of claims on time, we stay proactive at every step.
So, forget the stress of handling complicated behavioral health billing and let Eminence RCM handle it for you!
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