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Behavioral Health Billing Services

Behavioral health is the hardest specialty to bill and the easiest to underpay. Time-based session codes, carve-out payers that reroute your claims, telehealth modifier rules that shift by state, and utilization reviews that claw back paid sessions months later. We run the full behavioral health revenue cycle so your clinicians keep seeing patients and you keep the revenue you earned.

AAPC Certified
HIPAA Compliant
All 50 States
Starting at 2.49%
Get Your Free AuditCall 888-701-6090
2.49%Of collections
NoSetup fee or contract
AAPCCertified coders
50States served

Why behavioral health billing breaks where other specialties hold

A primary care claim is mostly mechanical. A behavioral health claim has to clear four checks that no other specialty stacks together: the code has to match documented time to the minute, the claim has to reach a payer that is often not the patient's medical plan, the telehealth fields have to match where the patient sat and how the session ran, and the service has to fall inside an authorization that may have a hard session cap. Miss any one of those and the claim denies or gets reviewed, and the practice usually finds out weeks later when the money does not arrive.

On top of that, behavioral health is the specialty payers audit most aggressively on utilization. A 60-minute session, a high share of 90837, a long course of weekly visits: each one can trigger an automated review and a takeback demand long after the claim was paid. Billing behavioral health well is less about submitting claims and more about submitting claims that survive a look back. That is the standard we build to.

The four problems that cost behavioral health practices the most

These are where the revenue leaks. Each one is a process we run on every claim, not a feature we mention once.

Time-based coding that survives review

90832 is 16 to 37 minutes, 90834 is 38 to 52, 90837 is 53 or more. The minute count has to be written in the note. We read the time before the claim goes out, so the code matches what the documentation actually supports and the 90837 holds up when a payer looks.

Carve-out payer routing

Many plans pay behavioral health through a separate entity such as Optum, Carelon, Magellan, or a state PIHP, not the medical MCO. We confirm who actually adjudicates behavioral health for each plan and send the claim there the first time, instead of letting it deny and age.

Telehealth fields that match the visit

POS 10 for the patient at home, POS 02 for another site, modifier 95 for audio and video, modifier 93 for audio only where it is covered. We keep a current per-payer grid and apply it per claim, because telehealth rules in behavioral health change more often than anywhere else.

Authorization and session limits

Payers cap sessions and require re-authorization. A lapsed auth turns a covered visit into a write-off. We track authorized sessions against what is actually billed and flag re-auth before the cap is hit, not after the denial.

THE AUDIT YOU WILL FACE

90837 utilization review and takeback defense

The 60-minute psychotherapy code pays more than the 45-minute code, so commercial payers watch it. Many run an automated rule that flags a provider once 90837 climbs past a threshold of their total psychotherapy volume, and they request records or issue a takeback for sessions already paid. The demand almost always rests on one thing: the note did not document the time clearly enough to support 53 minutes.

Our approach is prevention first. Before a 90837 is ever submitted, a coder confirms the note states the actual session time and that the clinical content fits a full session. When a payer does flag a claim, we respond chart by chart, citing the payer's own medical policy and the documented time, rather than letting the takeback stand by default. The practices that lose these reviews are the ones that never built the documentation discipline in the first place.

What we handle for behavioral health practices

The full revenue cycle for solo therapists, group practices, and psychiatry.

Individual, family, and group psychotherapy coding (90832 to 90853)
Psychiatric diagnostic evaluations (90791, 90792)
Psychotherapy add-on codes with E/M for psychiatry (90833, 90836, 90838)
Crisis psychotherapy coding (90839, 90840)
Psychological and neuropsychological testing (96130 to 96139)
Telehealth billing with correct POS and modifier per payer
Carve-out payer verification and claim routing
Authorization and session-limit tracking with re-auth alerts
90837 review response and takeback defense
Credentialing and enrollment for every license type
Denial work, appeals, and aged AR recovery
Patient statements and balance follow-up

Built for every provider type in your practice

Psychiatrists, psychologists, LCSWs, LPCs, and LMFTs each carry different enrollment rules, and some payers credential one license type but not another, or pay a different rate for the same code. A group with mixed license types is really several billing profiles under one roof. We enroll each provider correctly, track which panels are open, and code to the rules that apply to that clinician, so a session is never billed under a provider the payer will not pay.

Incident-to and supervised billing have their own rules in behavioral health. We set them up the way each payer requires, so a pre-licensed clinician's sessions bill cleanly instead of denying for provider eligibility.

Transparent pricing, no surprises

We start at 2.49% of collections, billed month to month. No setup fee, no long-term contract, no separate charge per claim or per provider. The fee covers coding, submission, denial work, authorization tracking, telehealth billing, and credentialing support.

Get a free billing review

Free behavioral health billing review

Send us your last 90 days. Our AAPC-certified coders will show you where sessions are leaking revenue, which claims are routed to the wrong payer, and what your 90837 exposure looks like. No obligation.

92%+ clean claim rate
2.49% starting rate
Results in 30 days

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92% clean claim rate
7 years in business
HIPAA compliant
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Behavioral Health Billing Questions

Straight answers on coding, carve-outs, telehealth, audits, and credentialing.

Both are individual psychotherapy codes, and the only thing that separates them is documented time. 90832 covers 16 to 37 minutes, 90834 covers 38 to 52 minutes, and 90837 covers 53 minutes or more. The session length has to be stated in the note as an actual number, not a range. We check the time entry against the code before the claim goes out, because a 90837 billed on a note that does not show 53 minutes is the single most common reason a payer downcodes or claws back a behavioral health session.
Many Medicaid plans and commercial plans do not pay behavioral health through their medical network. They carve it out to a separate managed behavioral health organization such as Optum, Carelon, Magellan, or a state PIHP. If the claim goes to the medical MCO instead of the carve-out entity, it denies, even though the patient is covered. We verify which payer actually adjudicates behavioral health for each plan and route the claim to the right one the first time.
We match the place of service to where the patient physically sits and the modifier to how the session was delivered. POS 10 is the patient at home and pays the higher non-facility rate. POS 02 is the patient at a different site and pays the facility rate. Modifier 95 marks an audio and video session, modifier 93 marks audio only where the payer allows it. Behavioral health is one of the few areas where audio-only is broadly reimbursed, but the rules shift by payer and state, so we keep a current grid and apply it per claim.
Yes. Commercial payers run automated reviews on 60-minute sessions and issue takeback demands when the documentation does not support the time. We defend those claims chart by chart, against the payer's own medical policy and the time documented in the note. The better outcome is prevention, so our coders confirm the note supports the level before the claim is ever submitted, which is what keeps most of these reviews from happening in the first place.
Yes. Psychiatrists, psychologists, LCSWs, LPCs, and LMFTs each enroll under different rules, and some payers credential one license type but not another, or pay a different rate for the same code. We handle enrollment and panel applications for every provider type in your practice and track when a panel is closed so you are not seeing patients you cannot bill for.
We start at 2.49% of collections, with no setup fee and no long-term contract, billed month to month. The fee covers coding, claim submission, denial work, authorization and session tracking, telehealth billing, and credentialing support. There is no separate charge per claim or per provider.

Stop losing therapy sessions to denials and takebacks

Behavioral health billing built around the audits you will actually face. AAPC-certified coders, 2.49% of collections, no setup fees, month to month.

Get Your Free AuditCall 888-701-6090