Mental Health Billing Services
Expert billing for psychiatry, psychology, and therapy practices. We handle the complexities of telemed, authorizations, and session coding so you can focus on patient care.
Mental Health Revenue Recovery
Specialized billing for behavioral health practices nationwide
Why Mental Health Billing Is Uniquely Complex
Mental health billing operates under a completely different set of rules than traditional medical billing. While a primary care practice bills for straightforward office visits and procedures, behavioral health providers navigate a maze of session codes, authorization requirements, and payer-specific policies that change constantly.
The shift to telemed has made this exponentially more complicated. What used to be a simple 90834 in-office therapy session is now a telehealth modifier question, a state licensure verification, and a "is this payer actually covering virtual sessions this week?" puzzle. Most general billing companies don't understand these nuances—and it costs you money every single day.
We built our mental health billing practice specifically to address these challenges. Our team understands the difference between 90834 and 90837, knows which payers require prior authorization for outpatient psychiatry, and tracks the constantly shifting landscape of telehealth reimbursement policies across all 50 states.
Mental Health Billing Expertise That Actually Understands Your Practice
Telemed Billing Mastery
95% of therapy sessions are now virtual. We handle telehealth modifiers (95, GT, GQ), place of service codes, and state-specific telehealth policies that vary wildly by payer.
Authorization Management
Proactive prior authorization tracking for psychiatry visits, intensive outpatient programs, and partial hospitalization. We submit 30 days before expiration—never letting care get interrupted.
Credentialing Acceleration
New providers credentialed 30-45 days faster than industry average. We know exactly which documents each payer needs and follow up aggressively to prevent delays.
Session Code Optimization
Maximize reimbursement through proper time documentation and code selection. We ensure 90837 gets billed when appropriate instead of defaulting to 90834.
Denial Prevention
Common mental health denials flagged before submission: diagnosis-procedure mismatches, missing modifiers, authorization gaps, and timely filing violations.
Transparent Reporting
Real-time dashboard showing authorization statuses, claim aging by payer, denial trends, and net collection rates—updated every 4 hours.
Telemed Billing for Mental Health: Getting It Right Every Time
Telehealth revolutionized mental health care delivery, but it created a billing nightmare. Every insurance company has different policies on what modifiers they accept, which platform qualifies as "interactive audio-video," and whether they even cover virtual sessions for certain diagnosis codes.
The modifier problem alone trips up most billers. Some payers want modifier 95. Others require GT. A few accept GQ. Medicare's rules differ from commercial insurance, which differs from Medicaid, which varies by state. Missing or using the wrong modifier results in instant denial—and most practices don't catch it until 30+ days later.
Place of service codes matter more than you think. Billing a telemed session with POS 11 (office) instead of POS 02 (telehealth) can trigger denials or underpayment. We ensure every virtual session is coded with the appropriate place of service, and we know which payers don't care about the distinction (yes, a few still exist).
State licensure verification is another critical piece. Many payers require proof that the provider is licensed in the state where the patient is physically located during the session. We track these requirements and alert you before credentialing issues arise. For more on our systematic denial prevention approach, see our RCM Intelligence framework.
Mental Health Session Codes: Billing What You're Actually Doing
One of the fastest ways mental health practices lose money is by under-coding therapy sessions. A 45-minute session billed as 90834 (38-52 minutes) pays significantly less than 90837 (53+ minutes)—yet many practices default to 90834 for everything because it's "easier" or they're afraid of audits.
The reality: if you're providing the service, you should bill for it. Proper time documentation protects you in audits and ensures appropriate reimbursement. We help practices implement time-tracking systems that capture session duration accurately, then bill the correct code based on actual time spent.
Psychiatry medication management gets even more complex. Some psychiatrists bill E/M codes (99213-99215) for med checks, while others use psychotherapy codes with add-on codes. There's no universal "right" answer—it depends on what you're actually doing in the session and how much time you're spending. We help psychiatrists select the appropriate code based on service content, not habit.
For practices seeing the same patient multiple times per week, we track frequency to prevent payer scrutiny. While there's no hard limit on how many sessions are "allowed," billing 4-5 sessions per week for months without proper documentation invites audits. We help you document medical necessity for intensive treatment when clinically appropriate.
Authorization Management: Keeping Care Uninterrupted
Prior authorization requirements for mental health services vary wildly by payer and plan. Some commercial plans require authorization after the initial evaluation. Others don't kick in until visit 10. Medicare Advantage plans have entirely different rules than traditional Medicare. And Medicaid? Every state has unique requirements.
The problem with most billing companies: they treat authorizations reactively. They wait for the denial to come back saying "prior authorization required," then scramble to get it retroactively (which rarely works). By that point, you've already provided 2-3 weeks of care that won't be paid.
For practices offering intensive outpatient programs (IOP) or partial hospitalization (PHP), authorization management is even more critical. These programs require detailed clinical documentation, regular updates to the payer, and careful tracking of authorized days versus days used. We handle the entire authorization lifecycle—initial submission, progress updates, and step-down authorizations when appropriate.
Appeal strategy matters for denied authorizations. When a payer denies an authorization request, we don't just accept it. We review the denial reason, gather supporting clinical documentation, and file peer-to-peer review requests when warranted. Our authorization approval rate after appeal is 92%—far higher than the industry average of 60-70%. For more on our systematic approach to denials, check our guide to the hidden consequences of denied procedures.
Credentialing: Faster Enrollment, Faster Revenue
The average mental health provider credentialing timeline is 90-120 days. That's 3-4 months of seeing patients you can't bill through insurance—meaning you're either collecting self-pay (difficult) or deferring billing until credentialing completes (risky). Either way, you're losing revenue.
We've shortened this to 60-75 days by understanding exactly what each payer needs upfront and submitting complete applications the first time. Most delays happen because applications are missing specific documents—a copy of your DEA certificate, proof of malpractice insurance with specific coverage limits, or a properly notarized attestation form.
- Complete application review before submission (zero missing documents)
- Weekly follow-up calls to payer credentialing departments
- Direct relationships with credentialing reps at major payers
- Expedited processing requests for high-volume payers
- Concurrent submission to multiple payers (not sequential)
For psychiatrists with prescribing authority, credentialing gets more complex because of DEA verification and state-specific controlled substance reporting requirements. We track these additional requirements by state and ensure compliance before submission. The goal: get you billing as quickly as legally possible.
Re-credentialing is just as important. When your malpractice insurance renews, when you move locations, or when your state license renews, payers need to be notified. Miss these updates and you risk being terminated from panels. We maintain a tickler file of every provider's key dates and handle re-credentialing proactively. Learn more about our systematic approach in our RCM Intelligence framework.
Common Mental Health Billing Denials (And How We Prevent Them)
Mental health claims face unique denial patterns that don't apply to other specialties. Understanding these patterns—and preventing them before submission—is how we maintain a 92% first-pass acceptance rate.
For a complete reference of denial codes and fix strategies, use our Denial Code Lookup Tool. It provides step-by-step resolution guidance for the most common billing denials, including mental health-specific scenarios.
Mental Health Billing FAQs
Do you handle billing for both therapists and psychiatrists?
Yes. We bill for all mental health provider types including licensed therapists (LCSW, LMFT, LPC), psychologists (PhD, PsyD), and psychiatrists (MD, DO). Each credential type has different billing rules and reimbursement rates, which we track by payer. Psychiatrists billing medication management follow different coding guidelines than therapists billing psychotherapy, and we handle both seamlessly.
How do you handle telehealth billing across different states?
Telehealth regulations vary significantly by state and payer. We maintain a database of state-specific telehealth policies and payer requirements, updated weekly. When a provider sees a patient in a different state, we verify licensure requirements, apply appropriate modifiers, and ensure the claim meets both state and payer guidelines. For providers licensed in multiple states, we track which payers cover interstate telehealth and which don't.
What's the difference between billing 90834 and 90837?
CPT code 90834 covers psychotherapy sessions of 38-52 minutes, while 90837 covers sessions of 53 minutes or longer. The reimbursement difference is typically $30-45 per session. Many practices default to 90834 for all sessions, leaving significant revenue on the table. We help implement time-tracking systems that capture actual session duration, ensuring you bill 90837 when appropriate. Proper documentation protects you in audits and maximizes reimbursement.
Do I need prior authorization for outpatient mental health services?
It depends on the payer and plan. Traditional Medicare doesn't require prior authorization for outpatient therapy. Many Medicare Advantage plans do after an initial evaluation period. Commercial insurance authorization requirements vary—some plans require it after 6-10 visits, others after 20-30 visits. We track authorization requirements for every payer-plan combination and submit requests proactively before your patients hit visit limits.
How long does credentialing take for new providers?
Industry average is 90-120 days. We've shortened this to 60-75 days through complete first-time applications and aggressive follow-up. Timeline varies by payer (Medicare is fastest at 30-45 days, some commercial payers take 90+ days). We submit to multiple payers concurrently rather than sequentially, and we prioritize payers based on your patient population to maximize revenue impact during the credentialing period.
Stop Losing Revenue to Mental Health Billing Complexity
Most mental health practices lose $75k-150k annually to preventable billing errors, authorization denials, and under-coding. Let's calculate your exact exposure and build a recovery plan.
Serving mental health practices nationwide. Based in Nevada, billing for all 50 states.
A-Z Medical Billing & Consulting was founded by Zain Vally, who identified persistent revenue cycle inefficiencies while operating Vally Medical Group, a multi-location occupational medicine practice across Hawaii. The hands-on experience of managing billing operations for practices spanning multiple islands revealed systematic problems in how most billing services approach denial management and specialty-specific coding. Our mental health billing expertise comes from years of working with behavioral health practices to solve the unique challenges of session coding, telehealth reimbursement, and authorization management. We built A-Z specifically to address these gaps through systematic prevention, aggressive pursuit of denied claims, and transparent reporting.