Mental Health Billing Articles & Guides

Mental health billing presents distinctive challenges driven by time-based coding requirements, evolving telehealth rules, and the ongoing complexity of insurance parity compliance. Psychotherapy CPT codes (90834 for 45-minute sessions, 90837 for 60-minute sessions, and 90832 for 30-minute sessions) are time-dependent, and the documented session duration must meet specific time thresholds for each code. Billing 90837 when the session lasted only 40 minutes, for example, constitutes upcoding and exposes the practice to audit liability. Psychiatric diagnostic evaluation (90791, 90792) and psychotherapy add-on codes for E/M services (90833, 90836, 90838) add additional layers of complexity.

Telehealth has become a permanent fixture in behavioral health service delivery, but the billing rules continue to evolve. Place-of-service codes, modifier 95 or GT usage, originating site requirements, and audio-only service coverage vary significantly across Medicare, Medicaid, and commercial payers. Practices must track these payer-specific rules to avoid claim denials and ensure proper reimbursement for virtual sessions. The Mental Health Parity and Addiction Equity Act requires that insurance plans apply the same coverage limitations to behavioral health services as they do to medical and surgical services, yet parity violations remain widespread and contribute to lower reimbursement rates for mental health providers.

Credentialing delays, low fee schedules, and high claim denial rates compound the financial pressures facing mental health practices. Medtransic provides specialized mental health billing services that address these challenges through accurate time-based code selection, compliant telehealth billing, proactive credentialing management, and parity-informed denial appeals. Our team helps psychiatrists, psychologists, and licensed therapists optimize their revenue cycles so they can focus on delivering quality patient care without the burden of billing complexities.

Mental Health Billing Articles

• Mental Health Billing Services: Psychotherapy Codes, Time-Based Traps, and the Parity Violations Costing Behavioral Health Practices Millions - Behavioral health billing operates under a fundamentally different set of rules than general medical billing. Time-based coding, payer-specific carve-outs, prior authorization walls, and Mental Health Parity Act violations create an environment where psychiatry and therapy practices lose 15 to 25 percent of earned revenue to preventable billing failures — far more than any other specialty. (17 min read)