Sept. 25, 2025
Effective Dec. 22, 2025, we’ll implement a new Clinical Payment and Coding Policy, CPCP051 Psychiatry/Psychotherapy Services-Professional Provider, with billing and coding guidance.
CPCP051 provides information for billing and claims processing for behavioral health psychiatry/psychotherapy services for professional provider claims.
This policy includes billing and coding general information for the following:
- Psychiatric diagnostic evaluations<
- Psychotherapy
- Psychotherapy with separately identifiable evaluation and management
- Crisis psychotherapy
- Family and group psychotherapy
- Interactive complexity
- Pharmacologic management
For more detail, refer to the new policy.
Important reminders: Always check eligibility and benefits first through Availity® Essentials or your preferred vendor, prior to rendering services. This step will confirm prior authorization requirements and utilization management vendors, if applicable.
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSIL. BCBSIL makes no endorsement, representations or warranties regarding third-party vendors and the products and services offered by them.
The information provided does not constitute coding or legal advice. Physicians and other health care providers should use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment, and to submit claims using the most appropriate code(s) based upon the medical record documentation, coding guidelines and reference materials.