Starting March 20, 2026, Headway is pausing the ability to bill 99215 + psychotherapy add-on codes for Anthem Colorado or Ohio patients. This means it will not be possible to combine these codes when you confirm sessions for these patients.
Why this is changing
We’ve noticed patterns with this billing combination that require further investigation. To protect our providers and their clients, we’re proactively prohibiting the use of this code combination for the time being.
We’re committed to building the right checks and educational resources to promote appropriate use of these codes so that we can re-enable them in the future.
About using this coding combination
99215 paired with an add-on psychotherapy code (90833, 90836, 90838) indicates extreme medical complexity and is reserved for an exceptional clinical moment where the patient presents with uncontrolled, high-risk symptoms and an elevated acuity beyond the provider's typical work with that patient.
What you can do instead
To ensure accurate coding, the level billed should always reflect the complexity you've documented.
For example, if you're managing a stable chronic condition plus medication, that might align with 99213. If conditions are unstable or more complex, documentation might support 99214. When in doubt, document fully and consult the 4-Step MDM guidelines or our Coding & Documentation desktop reference.
Our Coding and Documentation team members are experts in this area, and are here to support you at coding_and_documentation@findheadway.com.