Behavioral Health and Substance Use Disorders Billing in 2025: Streamlining the Process for Better Care

As the demand for mental health and substance use disorders services continues to grow, behavioral health billing in general has become increasingly complex. Providers must navigate evolving regulations, new diagnostic codes, and shifting reimbursement structures to ensure accurate billing and optimal financial outcomes. 

In 2025, the stakes are higher than ever, making it crucial for providers to stay informed about the latest billing changes and best practices. This guide outlines the most significant updates, challenges, and strategies for mastering behavioral health billing in 2025.

Key Updates in Behavioral Health Billing for 2025

• New and Refined Psychotherapy Codes: Codes like 90834 (45 minutes) and 90837 (60 minutes) now have more precise documentation requirements, including specific therapeutic approaches used.
• Digital Behavioral Health Codes: New codes, such as 989X1 (digital behavioral health interventions, initial setup) and 989X2 (monthly monitoring for digital interventions), address the growing use of digital mental health tools.
• Ultra-Brief Psychotherapy: 90868 for sessions lasting under 15 minutes, allowing providers to bill for shorter, high-impact interventions.
• Expanded Telehealth Codes: Permanent telehealth billing for behavioral health, including audio-only services in specific cases, reflecting the ongoing shift toward virtual care.

2. Enhanced Reimbursement for Collaborative Care
Collaborative care continues toto see expanded adoption in 2025. Updated billing codes like 99484 and 99492–99494 now recognize a broader scope of care team members, promoting interdisciplinary collaboration. This shift encourages closer collaboration between behavioral health specialists and primary care providers.

3. Prior Authorization and Documentation Standards
Insurers are tightening documentation requirements, emphasizing the need for detailed, time-specific notes that clearly link services to medical necessity. Key updates include:

• Time-Based Service Revisions: Codes like 90832 (16-37 minutes) now require precise time documentation to support billing.
• Interactive Complexity Add-On Codes: 90785 can now be used more broadly for sessions involving complex communication needs, such as those with children who have significant emotional reactivity.

Embracing Measurement-Based Care (MBC) in 2025

In 2025, measurement-based care (MBC) has become a foundational approach in behavioral health. By embedding routine outcome tracking into clinical workflows, providers can make informed decisions that lead to better results and higher reimbursement under value-based care models. Here’s how MBC is shaping behavioral health billing in 2025:

Key Trends in MBC for 2025

• Integration of Mental and Physical Health: MBC supports the growing trend of integrating behavioral health into primary care, emphasizing the link between chronic diseases and mental health challenges. This holistic approach improves patient/client outcomes and supports value-based care models.
• Broader Use of Data-Driven Insights: Behavioral health professionals are increasingly using data from patient-reported outcomes (PROs) to customize treatment plans, track symptom progression, and enhance the overall quality of care.
• Enhanced Team Collaboration: With a focus on whole-person care, MBC promotes collaboration among psychiatrists, social workers, nurses, and other specialists to create personalized, data-informed care plans.
• Advancements in Digital Health and AI: AI-driven tools and digital platforms now play a critical role in MBC, allowing providers to analyze real-time patient/client data, predict outcomes, and adjust care plans proactively.
• Patient-Centered Care: MBC emphasizes shared decision-making and active patient/client participation, improving their satisfaction and reducing dropout rates.

Core Components of MBC

MBC relies on three essential components to drive better clinical outcomes:

1. Routine Data Collection: Regularly collecting patient/client-reported outcomes (e.g., symptom scales, functional assessments) throughout the course of treatment to monitor progress and adjust care as needed.
2. Timely Feedback: Sharing data with patients to provide transparency and encourage active participation in their care, fostering stronger therapeutic alliances.
3. Personalized, Data-Driven Interventions: Using collected data to guide clinical decisions, ensuring that treatments are evidence-based and tailored to each person’s unique needs.

Benefits of MBC for Providers and Patients/Clients

• Improved Outcomes: Research consistently shows that MBC improves patient outcomes, reduces treatment dropout rates, and lowers the risk of clinical deterioration (Fortney et al., 2017; Lewis et al., 2019).
• Cost Savings: MBC is associated with decreased healthcare costs by reducing unnecessary interventions and optimizing treatment efficiency (De Jong et al., 2021).
• Stronger Patient/Client-Provider Relationships: Regular data sharing builds trust and encourages collaboration, enhancing patient satisfaction and engagement.

Practical MBC Strategies for 2025

• Routine Symptom and Outcome Measures: Use standardized tools like PHQ-9, GAD-7, or PROMIS to track patient progress and inform treatment decisions.
• Data Review and Collaborative Planning: Regularly review progress data with patients to set realistic goals and adjust care plans as needed.
• Predictive Analytics and AI: Leverage AI to identify those at-risk, personalize interventions, and improve overall outcomes.
• Expanded Access through Telehealth: Use digital platforms to reach underserved populations and provide consistent, data-driven care.

We Understand Your Needs

Advanced Data Systems RCM, supports a diverse range of mental health and substance
use disorders providers, clinicians, and facilities, including:

• Outpatient Mental Health (Psychiatry/Therapy) - Learn More
• Outpatient Substance Abuse (MAT, IOP, PHP) - Learn More
• Inpatient Substance Abuse (Residential and Detox) - Learn More

Partner with ADSRCM's outsourced services to streamline your billing, optimize reimbursements, and reduce administrative burdens, so you can focus on delivering high-quality care. Access the ONC-certified MedicsCloud EHR for specialty-specific clinical charting or keep your existing EHR interfaced with us. Alternatively, the MedicsCloud Suite from ADS is available if in-facility automation is preferred.

For more information on behavioral health billing solutions, visit ADS Behavioral Health and Addiction Treatment.