If your telehealth claims started bouncing over the past year, this is the story behind it. The AMA rebuilt telehealth coding in 2025. Seventeen new codes came in, and the old phone codes went out. Then every commercial payer made its own call: some take the new codes, some pay none of them, and a few pay only half the family. Nobody sent therapists a plain-language memo. So here is one. Ten minutes here can save you a month of resubmits.
What changed on January 1, 2025?
A quick refresher first. A CPT code is the five-digit number on your claim. It tells the payer what service you gave. The AMA owns the code set and updates it every January.
The CPT 2025 update built a brand-new telemedicine section with 17 new codes, effective January 1, 2025 (AMA, February 2025). They come in three buckets:
- 98000-98007: live video visits (the payer term is "synchronous audio-video")
- 98008-98015: phone-only visits ("synchronous audio-only")
- 98016: one brief virtual check-in
The same update deleted the old telephone codes, 99441-99443 (AMA, February 2025). If those still sit in your billing software favorites, they are gone from the code set. One safety note for group practices: check your saved claim templates and clearinghouse rules too. A dead code hiding in a template will bounce all on its own.
On paper, it looks tidy. Then the payers got hold of it.
Do the new codes replace your therapy codes?
No. And this is the part almost nobody says out loud to therapists.
The 98000-series codes are E/M codes. E/M means "evaluation and management." Those are the visit codes physicians and nurse practitioners bill. The AMA is direct about it. Peter Hollmann, MD, of the CPT Editorial Panel, put it plainly: "these are E/M services" (AMA, February 2025). Masters-level clinicians, which covers most LCSWs, LMFTs, and LPCs, generally cannot bill E/M codes at all. If you work alongside a psychiatric NP or MD, this is their alphabet. They can use the new codes when a payer allows it. You mostly cannot.
Your codes did not move. 90791 is still 90791. The 90832-90838 family is still yours, on video or in the office (AMA, February 2025). A 90837 over telehealth is still a 90837, with a telehealth place-of-service code and whatever modifier the payer asks for. So when a billing newsletter tells a therapist to "switch to the new telehealth codes," that advice is wrong for most of us. Do not switch.
So why care about 17 codes most of us cannot even use? Because commercial payers rebuilt their telehealth rules around them. The churn lands on your modifiers, your place-of-service codes, and your phone sessions. That is where claims break.
Two more terms, then the payers. A modifier is a short tag added to a code. Modifier 95 means the visit was live video. Modifier 93 means it was phone only. POS is the place-of-service code on the claim. POS 02 means telehealth with the client somewhere other than home. POS 10 means the client was at home.
Which commercial payers accept the new codes?
Short version: they split, sometimes inside the same brand.
Why the split? New codes arrive with no payment history behind them. Each payer had to decide what the new visits were worth, and each one decided alone. Your claims now live in the space between those choices.
UnitedHealthcare. UHC's commercial telehealth policy (2026R0046A, version January 1, 2026) does not pay codes 98000-98015 as billed (UnitedHealthcare policy PDF, January 2026). It routes them to a replacement-codes policy instead. Translation: keep billing your standard codes with POS 02 or 10. For phone-only care, UHC pays only services on the AMA's audio-only list, called CPT Appendix T, billed with modifier 93. Modifiers 95, GT, and GQ are informational only there. They describe the visit, and they do not change payment. The policy history even logs a January 1, 2025 revision "for handling of codes 98000-98015." The reroute was on purpose. Your move: nothing new for video sessions. For phone sessions, check that the service sits in Appendix T and add modifier 93.
Aetna. Aetna accepts the video codes, 98000-98007, on commercial plans, per reporting from Part B News, April 2025. For phone-only visits, Aetna points providers to regular office visit codes, so the audio-only codes 98008-98015 are out. One caution: that detail comes from trade press, and Aetna's own posted telehealth PDF has not caught up to the new series. Confirm in Availity before you change a single claim.
Cigna. Cigna's public provider page still describes the older setup: POS 02 with modifier 95, GT, or GQ (Cigna provider page, undated, accessed July 2026). It asks providers not to bill modifiers 93 or FQ "at this time," and to hold POS 10 "until further notice." It does not mention the 98000 codes at all. It does say covered virtual care pays at 100% of the face-to-face rate. Behavioral health runs on separate Evernorth guidance, so verify there before you bill. Your move: stay on POS 02 and modifier 95 for Cigna video visits until Evernorth tells you otherwise in writing.
The Blues. Blue Cross Blue Shield plans split four ways on the same codes in 2025 (Part B News, April 2025):
- BCBS North Dakota pays both ranges, 98000-98007 and 98008-98015
- BCBS South Carolina and BCBS Vermont pay only the video codes
- BCBS North Carolina takes none of them and wants standard office codes
- BCBS Michigan began paying both ranges on July 1, 2025
That is five plans and four different answers, all reading the same AMA code book. If you hold contracts with more than one Blue, check each one separately. The brand does not predict the rule.
Why does this hit therapy practices hardest?
Because for therapy practices, telehealth is the main road, and the traffic keeps growing.
FAIR Health tracks the largest collection of commercial claims in the country, over 4 billion claim records a year. Its tracker shows telehealth claim lines rose 10.1% between Q4 2025 and Q1 2026, from 5.01% to 5.51% of all medical claim lines (FAIR Health via PR Newswire, June 2026). Mental health was the top telehealth diagnosis group in every age bracket. And 52.1% of patients with telehealth claims had a mental health diagnosis.
Over half. In commercial claims, telehealth care is mostly mental health care. So when the billing rules splinter payer by payer, therapy practices absorb most of the rework.
Phone sessions are not a relic, either. They are how care reaches clients without a private room, a strong connection, or a laptop. When a payer buries audio-only under a special list and one specific modifier, those are the sessions whose claims wobble first.
To be straight with you: nobody has published a solid denial count for this code family yet, so we will not print one. The pattern is visible anyway. Splits like these produce denials, resubmits, and long hold music. Every round is unpaid admin stacked on the documentation load you already carry. And it comes out of commercial rates that were thin to begin with.
Six Fixes to Make Now
Six moves. None of them takes a full day. If you run a NY, NJ, or CT practice, your commercial panel is probably heavy on UHC, Aetna, Cigna, and a Blue or two, so this list covers most of it.
1. Build a one-page payer sheet. List your top commercial payers. For each one, write down the code, the POS, the video modifier, and the phone modifier. Keep it next to your monitor. 2. Keep billing your psychotherapy codes. Do not switch to the 98000 series unless a payer tells you to in writing. Most masters-level clinicians cannot bill them anyway. 3. Check every phone-session rule. Audio-only is where payers differ most. UHC wants an Appendix T service with modifier 93. Cigna says skip 93 for now. Aetna reportedly wants office codes. Same session, three answers. 4. Confirm POS 02 versus POS 10 for each payer. Cigna's public guidance still says hold POS 10. UHC accepts both. Do not assume one setting fits every plan. 5. Appeal with the payer's own PDF. When a telehealth claim denies, cite the payer's policy number and effective date back to them. It is the same playbook that works for parity denials: document, cite, resubmit. 6. Re-check policies every January and July. Payer PDFs are living documents. UHC's current version is dated January 1, 2026. BCBS Michigan changed its rule mid-year. Put both months on the calendar.
CPT 2026 Adds 13 Behavioral Health Codes
Some genuinely good news took effect January 1, 2026.
CPT 2026 added 13 behavioral health services to the AMA's official telehealth appendixes (APA Services, October 2025). Appendix P is the AMA's approved video list. Appendix T is the phone-only list. Newly listed:
- Group psychotherapy (90853)
- Group caregiver behavior management training (96202, 96203)
- Developmental testing (96112, 96113; video list only)
- Psychological and neuropsychological testing evaluation (96130-96133)
- Test administration and scoring (96136-96139)
Being on the AMA list does not force a commercial payer to pay. Everything above proves that. But it hands you a reference point when you call. The service is on the official 2026 telehealth list, so ask the rep to show you the written policy that excludes it.
One last honest note. Every fix on this page is unpaid admin, stacked on notes, portals, and the rest of the busywork the system hands you. That pile is the reason VibeCheck.luxury exists: clinician-built tools that give therapists time back for actual clinical work, made by a clinician who bills these same commercial payers. If you would rather compare notes than read another payer PDF, book a call anytime.
FAQ
Do the new 98000-98016 codes replace 90837 for telehealth therapy?
No. The AMA classifies the 98000 series as E/M services, and psychotherapy codes 90791 and 90832-90838 were not deleted or replaced (AMA, February 2025). Keep billing your normal therapy codes with the telehealth POS and the modifier your payer specifies.
Which commercial payers accept the new telehealth codes?
It splits. Aetna accepts the video codes 98000-98007 but not the phone-only codes (Part B News, April 2025). UnitedHealthcare's commercial policy pays none of 98000-98015 (policy 2026R0046A, January 2026). BCBS plans vary by state, and Cigna's public guidance does not list the codes at all.
What modifier do I use for a phone-only session in 2026?
It depends on the payer. UnitedHealthcare wants an Appendix T service with modifier 93 and POS 02 or 10 (January 2026 policy). Cigna's public guidance says do not bill 93 for now and points to 95, GT, or GQ with POS 02. Confirm your payer's current policy before you bill.
Is telehealth still growing for mental health?
Yes. FAIR Health's commercial claims tracker showed telehealth claim lines up 10.1% from Q4 2025 to Q1 2026, and mental health was the top telehealth diagnosis category in every age group, with 52.1% of telehealth patients carrying a mental health diagnosis (FAIR Health, June 2026).