Behavioral health billing is fundamentally different from general medical billing. From complex authorization workflows to session-length modifiers, you need a billing partner who understands every nuance of your practice.
General billing companies lack the specialized knowledge needed for mental health claims. Here's what sets your practice apart — and why it matters.
Most behavioral health services require pre-authorization that varies wildly between payers. Missing a single step means denied claims and lost revenue.
Psychotherapy codes require precise time-based modifiers. A 38-minute session billed as 45 minutes triggers immediate audits and recoupment requests.
Combining E&M codes with psychotherapy add-ons, diagnostic evaluations, and pharmacologic management demands exact CPT pairing knowledge.
Mental Health Parity Act enforcement means payers must match medical/surgical benefits. Navigating parity violations requires dedicated expertise.
LCSWs, LMFTs, LPCs, and psychologists each face different payer enrollment requirements. One missing credential blocks your entire revenue stream.
Behavioral health claims are denied for reasons general billers often miss: authorization limits, session-time thresholds and add-on code pairing. Without specialized follow-up, many of those denials are never resubmitted.
Every service we offer is specifically designed for the workflows, codes, and payer requirements unique to mental health and substance use disorder practices.
We verify benefits and secure authorizations before the patient walks in — not after the claim is denied. Our system tracks authorization units, expiration dates, and extension requirements in real time.
Our certified coders specialize in mental health CPT codes — from 90832 through 90853, psychiatric evals, and interactive complexity add-ons. Every claim reflects the actual service delivered.
Behavioral health denials demand specialized appeal language. Our team understands payer-specific denial reasons and crafts targeted appeals that reference parity law, medical necessity criteria, and clinical documentation standards.
Behavioral health CPT coding is one of the most complex subsets in medical billing. Our team maintains an continuously updated knowledge base of current code sets, payer-specific bundling rules, and documentation requirements — so every claim goes out clean the first time.
We track annual CPT updates, LCD/NCD changes, and payer policy shifts that affect how behavioral health services are billed and reimbursed across all major commercial and government payers.
| CPT Code | Service | Time |
|---|---|---|
| 90832 | Psychotherapy, 30 min | 16–37 min |
| 90834 | Psychotherapy, 45 min | 38–52 min |
| 90837 | Psychotherapy, 60 min | 53+ min |
| 90833 | Psychotherapy add-on, 30 min | With E&M |
| 90836 | Psychotherapy add-on, 45 min | With E&M |
| 90838 | Psychotherapy add-on, 60 min | With E&M |
| 90785 | Interactive complexity | Add-on |
| 90853 | Group psychotherapy | Per session |
| 90863 | Pharmacologic mgmt with psychotherapy | Per session |
| 90791 | Psych diagnostic evaluation | Without medical |
| 90792 | Psych diagnostic evaluation | With medical |
| 96132 | Neuropsych testing eval | First hour |
A streamlined onboarding and billing workflow designed specifically for behavioral health practices — from solo therapists to large group practices.
Deep-dive into your current billing, coding patterns, and revenue leaks
Seamless connection to your EHR — no double entry, no workflow disruption
Clean claims out the door within 24 hours of service delivery
Real-time ERA posting, payment reconciliation, and variance alerts
Monthly performance dashboards with actionable revenue recommendations
Each subspecialty has its own coding nuances, payer requirements, and compliance considerations. We have dedicated teams for each.
Medication management, diagnostic evaluations, and combined E&M + psychotherapy billing
Individual, family, couples, and group therapy with accurate time-based code selection
SUD assessment, MAT billing, intensive outpatient, and residential treatment coding
Interactive complexity add-ons, parent involvement coding, and school-based services
Telehealth modifier management, interstate licensing compliance, and audio-only billing
96130-96133 testing codes, interpretation billing, and complex assessment bundling
PHP billing, daily service codes, and structured program documentation support
Sliding-scale billing, grant-funded services, and multi-payer coordination
Behavioral health data carries heightened sensitivity. Our compliance framework is built for the unique regulatory requirements of mental health practices.
Dual compliance with HIPAA and federal substance use confidentiality regulations for all data handling and transmission.
Active monitoring of payer compliance with parity requirements. We flag disparities and support formal complaints when needed.
Ongoing monitoring of provider license status, NPI active status, and state-specific enrollment requirements across all practice locations.
Common questions from behavioral health providers considering outsourced billing.
Behavioral health billing involves time-based CPT codes (90832-90838), prior authorization requirements that vary by payer and service type, interactive complexity modifiers, parity law considerations, and higher denial rates. General billing companies often lack expertise in these areas, leading to revenue leakage for mental health practices.
Yes. We manage all telehealth billing including correct place-of-service codes (02 for telehealth), modifier application (95, GT where applicable), audio-only visit coding, and interstate licensing compliance tracking. We stay current with post-pandemic telehealth policy changes that affect reimbursement.
We integrate with all major behavioral health EHR platforms including AdvancedMD, DrChrono, Kareo, TherapyNotes, SimplePractice, Valant, CarePaths, Welligent, and others. For custom or legacy systems, we offer secure file-based integration and manual entry workflows that maintain the same turnaround times.
We provide documentation templates and guidelines to your clinical team so they capture the required time elements. Our coding team cross-references documented time against the billed code before submission. If there's a mismatch, we flag it for correction before the claim goes out — preventing downstream audits.
Pricing depends on practice volume, payer mix and the services you need, and there are no long-term contracts. We give you a written quote after a short review of your current billing.
Absolutely. We handle full credentialing and enrollment for psychiatrists, psychologists, LCSWs, LMFTs, LPCs, and other licensed behavioral health providers. This includes CAQH profile management, payer-specific applications, NPI registration, and ongoing re-credentialing — so your new providers can bill from day one.
Every denied claim, every missed authorization, every incorrect modifier is revenue that should be in your practice. Let our behavioral health billing specialists fix the leaks.
See exactly how much revenue your practice is leaving on the table. Our behavioral health billing specialists will analyze your current processes and identify improvement opportunities — no obligation, no sales pressure.
We'll identify where claims, coding, or collections are costing you money.
Get actionable insights you can use immediately, whether you work with us or not.
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