Eligibility & Verification
Coverage checks before every visit.
Specialty Billing
Behavioral Health Medical Billing
Behavioral health billing demands careful authorization tracking and parity awareness across payers. We manage pre-auth, visit limits, and time-based coding so your sessions are reimbursed without interruption.
The Challenge
Behavioral Health billing, solved
We understand the billing complexities unique to behavioral health and build them into every claim.
- Pre-authorization and visit limits
- Time-based session coding
- Parity and payer variability
What we focus on
- Psychotherapy & group codes
- Authorization tracking
- Telehealth compliance
Coding Focus
Behavioral Health code sets we work in
The CPT/HCPCS procedure families and ICD-10 diagnosis groups our certified coders handle for this specialty every day.
Common CPT / procedure codes
- 90791–90792Psychiatric diagnostic evaluation intake encounters
- 90832–90838Time-based individual psychotherapy sessions
- 90846–90853Family and group psychotherapy services
- 90839–90840Psychotherapy for crisis encounters
ICD-10 diagnosis focus
- F32–F33 depressive disorders
- F40–F48 anxiety and stress-related disorders
- F10–F19 substance use disorders
- Severity and episode specificity to support level of care
Code references are shown as general identifiers for illustration. Actual code selection always follows current payer rules and your provider's documentation.
Clean Claims
Modifiers, denials & billing rules we manage
How our team keeps behavioral health claims compliant — the modifiers that matter, the denials we prevent, and the guidelines we follow.
Key modifiers
- 95
Indicates a therapy session delivered by real-time audio-video telehealth.
- 25
Supports a separate E/M service billed with a same-day psychotherapy add-on.
- 59
Distinguishes separately billable services provided within a single encounter.
- AJ
Identifies a clinical social worker as the rendering provider when payers require credential-level reporting.
Common denials & fixes
Authorization missing or session units exhausted.
Track authorized session counts and renew authorizations before the allotted units run out.
Timed code does not match documented session length.
Record face-to-face start and stop times and select the psychotherapy code that fits the duration.
Telehealth modifier or place-of-service omitted.
Apply the correct telehealth modifier and place-of-service code per each payer's policy.
Rendering provider credential not payable for the code.
Verify licensure and payer enrollment before assigning the billed service to a clinician.
Billing guidelines
- Track authorization units and session limits, renewing before they lapse.
- Choose timed psychotherapy codes strictly by documented face-to-face minutes.
- Apply the payer's required telehealth modifier and matching place-of-service code.
- Confirm the rendering clinician's credential is eligible for the service billed.
End-to-End
What we handle for Behavioral Health
A complete revenue cycle service tailored to your specialty.
Specialty Coding
Certified, specialty-trained coders.
Charge Entry & Claims
Clean, accurate claim submission.
Payment Posting
ERA/EOB posting and reconciliation.
Denial & AR Management
Appeals and aggressive AR recovery.
Reporting & Analytics
Real-time KPIs and insights.
98%
Clean claim rate
30%
Average revenue lift
24/7
Operations coverage
HIPAA
Compliant processes
FAQ
Behavioral Health billing — FAQs
Yes — our certified coders are trained on specialty-specific rules, code sets, and payer policies, and we assign coders with experience in your specialty.
We work in your current practice management system and EHR, so your workflows and reporting stay intact while we handle the billing.
Through accurate specialty coding, front-end eligibility checks, clean claim submission, and relentless denial and AR follow-up — typically lifting first-pass acceptance and net collections.
Always. We use strict access controls, encryption, signed BAAs, and audit trails to protect patient data.
More Specialties
Other specialties we bill for
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