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.
Anita Schmidt, BS, RHIT, AHIMA-approved ICD-10-CM/PCS Trainer
Ms. Schmidt has expertise in Level I Adult and Pediatric Trauma hospital coding, specializing in ICD-9-CM, ICD-10-CM/PCS, DRG, and CPT coding. Her experience includes analysis of medical record documentation, assignment of ICD-10-CM and PCS codes, DRG validation, as well as CPT code assignments for same-day surgery cases. She has conducted coding training and auditing, including DRG validation, conducted electronic health record training, and worked with clinical documentation specialists to identify documentation needs and potential areas for physician education. Most recently she has been developing content for resource and educational products related to ICD-10-CM and ICD-10-PCS. Ms. Schmidt is an AHIMA-approved ICD-10-CM/PCS trainer and is an active member of the American Health Information Management Association (AHIMA) and the Minnesota Health Information Management Association (MHIMA).
Top