Our Services
Mental Health Billing Services
Accurate billing and reimbursement are vital for mental health practices, where every claim must reflect the complexity of therapy, counseling, and psychiatry services.
Mental Health Billing
Mental health billing comes with unique challenges, from multiple session types and time-based coding to strict compliance and documentation requirements. At Practice Claim, our Mental Health Billing Services are designed to simplify your revenue cycle and maximize reimbursements.
We work with psychiatrists, psychologists, therapists, counselors, and behavioral health clinics nationwide. Our certified mental health billers and coders understand the rules and requirements of commercial insurers, Medicare, and Medicaid. By outsourcing your billing to our team, you reduce errors, minimize claim denials, and get paid faster, so you can focus on patient care.
Components of Mental Health Billing
1. Patient Eligibility Verification & Authorizations
Before services are provided, our team confirms patient demographics, insurance coverage, co-pays, deductibles, and pre-authorization requirements. This prevents billing surprises and ensures a smooth reimbursement process.
2. Specialized Coding and Documentation
Mental health billing relies heavily on time-based CPT codes, therapy modifiers, and accurate session documentation. We handle coding for:
Psychotherapy sessions (CPT 90832, 90834, 90837)
Psychiatric diagnostic evaluations (CPT 90791, 90792)
Group therapy (CPT 90853)
Crisis intervention (CPT 90839, 90840)
Telehealth services with appropriate modifiers
We ensure every claim is backed by accurate notes and proper coding to meet payer compliance standards.
3. Streamlined Claims Submission and Tracking
Claims are submitted electronically with payer-specific requirements built in. We monitor each claim until payment is received, resolving rejections or errors quickly to speed up reimbursement.
4. Transparent Patient Billing and Payment Posting
Our billing specialists handle patient statements with clear, professional formatting. Payments are posted accurately, reducing confusion and improving patient satisfaction.
5. Denial Management and Appeals
Mental health practices often face denials related to session length, lack of documentation, or authorization errors. We analyze each denial, appeal with supporting records, and recover revenue that might otherwise be lost.
Challenges in Mental Health Billing
Frequent Coding Updates
Mental health billing requires constant attention to CPT and ICD-10 updates. Codes for psychotherapy, behavioral therapy, and telehealth often change, making it critical for practices to stay current to avoid claim rejections.
Insurance Coverage Variability
Unlike other specialties, mental health benefits differ significantly across insurance providers. Limitations on sessions, coverage exclusions, and parity law compliance make billing highly complex without expert guidance.
Authorization and Documentation Requirements
Mental health services often require prior authorization and detailed session documentation. Missing notes or incorrect authorization can result in claim denials and payment delays, directly impacting practice revenue.
Advantages of Outsourcing Mental Health Billing
Outsourcing your mental health billing to our specialized service can provide numerous benefits, including:
Expert Handling of Complex Procedures
Our coders are very well versed with detailed cardiovascular procedures as well as the codes to be billed and hence any billing errors are almost eliminated.
Faster Reimbursement
Our claim submission is integrated and we also effectively handle denials, thus enhancing timely cash receipts.
Reduced Administrative Burden
Our extensive billing services save your in-house team time to attend to the patients only by providing minimal interference work and pressures.
Cost Efficiency
The decision to outsource can be beneficial because outsourcing is cheaper than having an independent billing department for small practices.
Data Analytics and Reporting
We offer comprehensive billing reports and analysis that can show you your business revenue status and areas of compliance concern.
Our Mental Health Billing Services
Our mental health billing services are comprehensive, covering every aspect of mental health procedures.
Therapy and Counseling
Individual, family, and group therapy billing
Psychiatry Services
Diagnostic evaluations, medication management
CPT and Modifier Compliance
Time-based codes, telehealth modifiers
Claim Management
Submission, AR follow-up, appeals
Compliance Support
HIPAA and payer policy adherence
Why Choose Practice Claim for Mental Health Billing?
Certified Coders
Our certified team is always updated on the latest in mental health coding.
Compliance Assurance
We strictly follow the best practices in the industry and ensure our processes are in compliance with the most recent standards.
Advanced Revenue Cycle Management
We take full charge of billing from submission of claims, through Claims Management to posting of payments to enhance revenue.
Customized Solutions
Our services suit the needs of the individual practice, a group practice or a multispecialty center.
Proven Track Record
Mental health billing services have been successfully provided by us to practices all over the country backed by similar improvements in collections and denials.
Frequently Asked Questions
Mental health billing involves time-based CPT codes, frequent prior authorizations, and varying payer rules for therapy sessions, psychiatric evaluations, and telehealth. Providers also face stricter documentation requirements compared to other specialties.
Some of the most frequently used CPT codes include:
- 90791 – Psychiatric diagnostic evaluation
- 90832, 90834, 90837 – Psychotherapy sessions (30, 45, 60 minutes)
- 90846, 90847 – Family or couple therapy
- 90853 – Group psychotherapy
- 99213, 99214 – Evaluation and management (E/M) for medication management
- 96127 – Brief emotional/behavioral assessment
Our coders ensure accurate use of CPT codes and modifiers to maximize reimbursement.
Many payers require pre-authorizations, session limits, and medical necessity documentation. Without these, claims may be denied. Our billing team manages prior authorizations and ensures claims meet payer criteria.
Yes. Most insurers now reimburse for tele-mental health services, but coding rules, place of service codes, and modifiers (e.g., 95) vary by payer. We ensure proper coding and compliance to secure reimbursement.
We verify insurance eligibility, secure authorizations, ensure correct coding, and use proactive denial management. Our team reviews every denial, files appeals, and resubmits claims to recover revenue.
