How Telehealth Affects Mental Health Billing in 2025

Telehealth has really transformed how people get mental health support. What used to be a backup option during the pandemic is now fully integrated into therapy, psychiatry and behavioral health services. In 2025, it’s not just about being digital, it’s about doing it right, billing it accurately and making sure reimbursements keep up.

As a mental‑health provider you now face two intertwined tasks: delivering compassionate care and managing a modern, often complex mental health billing workflow. Understanding how telehealth impacts billing will help you keep your practice financially healthy while staying focused on patient outcomes.

The Evolution of Telehealth in Mental Health Care

A few years ago, telehealth mainly meant video sessions. Today it includes live virtual therapy, audio-only check-ins, hybrid models, and even remote patient monitoring. This flexibility benefits patients but also introduces new billing considerations for mental health providers.

Coding matters. You pick codes based on how you delivered the session. In 2025, insurance will cover phone sessions more than before. Many states require equal pay for virtual and in-person visits. You have to document consent and patient location or insurance won’t pay.

Billing Codes and Compliance Updates for 2025

Even though the core therapies remain the same, how you bill them for telehealth has additional details. The service still mirrors traditional care, but reimbursement requires correct modifiers, location codes, and service designations.

Service Type	Example CPT/HCPCS Codes	Key Notes
Individual Psychotherapy	90832, 90834, 90837	Audio or video allowed (verify payer)
Psychiatric Diagnostic Evaluation	90791, 90792	Requires documentation of telehealth consent
Medication Management (Psychiatry)	99213‑99215 + Modifier 95	Modifier 95 indicates telehealth encounter
Group Therapy	90853	Many payers still require video‑only for groups
Remote Monitoring (Behavioral)	99457, 99458	For ongoing behavioral data monitoring

Tip: Before submitting claims, check whether the payer allows audio‑only sessions and what modifier/“place of service” applies.

What’s New in 2025: Medicare, Medicaid & Private Payers

Medicare & Medicaid

The major governmental payers have extended many of the telehealth flexibilities introduced during the pandemic into 2025. That means broader access for urban and rural patients alike. But to get reimbursed correctly, you still need to record patient location, session format and consent. State Medicaid programs now generally include behavioral telehealth—but since each state is different, verifying state‑specific rules is wise.

Private Insurance

Many private payers are shifting toward value‑based care, meaning mental health reimbursements may tie more closely to outcomes or engagement. Some also require prior authorization services for longer-term virtual care models. Regularly reviewing your contracts with private payers ensures you won’t be caught off‑guard.

Common Billing Challenges for Mental Health Providers

Even with clearer guidelines, mistakes still happen. Here are typical issues:

• Missing or incorrect modifiers (e.g., Modifier 95, “place of service” POS 10)
• Using outdated CPT codes that no longer reflect telehealth services
• Claims denied because the telehealth consent wasn’t documented
• Overlooking state rules when treating patients across state lines

Regular audits and keeping your team trained can prevent most of these issues, and simply double-checking patients’ insurance coverage and eligibility goes a long way toward avoiding denied claims.

Financial Impact: Traditional Model vs Telehealth Model

Telehealth changes the financial side of your practice as much as the clinical side. Lower overhead, fewer no‑shows and faster turnaround on claims are common benefits. Here’s a quick comparison:

Aspect	Traditional Model	Telehealth Model
Overhead Costs	Higher (rent, utilities, front desk)	Lower (digital setup, fewer onsite constraints)
Appointment Flexibility	Mostly clinic hours	Evening/weekend sessions more feasible
No‑Show Rate	15‑25% typical	Often under 10% with telehealth
Reimbursement Rate	Usually flat per visit	Depends on payer, session type and location
Claim Processing	Often slower	Faster with modern e‑claims and workflows

That means mental‑health practices can run leaner, serve more patients virtually, and maintain strong cash flow.

Practical Tips to Streamline Telehealth Billing

• Check payer contracts quarterly. Confirm telehealth pays the same as in-person visits.
• Get billing software made for telehealth. It adds modifiers like 95 and POS 10 automatically.
• Write everything down. Patient location. Video or phone. Start time. End time. Signed consent.
• Watch for policy updates. Payers change telehealth rules frequently. Set calendar reminders.

Best Practices for Accurate Telehealth Claims

• Check insurance before every session.
• Write down if it was video or phone.
• Record start and end times for time-based codes.
• Store signed consent forms safely.
• Use HIPAA platforms that log encounter details.
• Good documentation works for everything—therapy sessions, MRI billing, CT scans, and ultrasounds. Write it down correctly and you get paid.

These steps follow the same principles applied in everyday billing, whether handling routine sessions or procedures such as MRI, CT, and ultrasound, emphasizing the importance of accurate documentation across all services.

Steps to Future‑Proof Your Billing in 2025

• Try AI billing tools. They catch errors before you submit claims.
• Treating patients in other states? Learn interstate licensing rules and billing requirements.
• Sign up for CMS and payer email updates. Stay ahead of policy changes.
• Hire a billing specialist who understands mental health telehealth. They keep you compliant.

Embracing the New Normal

Telehealth isn’t a temporary fix or a side option; it’s now a vital part of modern mental health care. More patients prefer the convenience, comfort and flexibility it offers, and as a provider, you’re part of the shift.

But doing it well means more than opening a video link, it means staying current with codes, documentation protocols and payer policies. When you combine your clinical empathy with billing precision, you create a practice that delivers excellent care and stays financially sound.