Mental Health & Behavioral Billing Services Experts
Maximize your behavioral health practice revenue with specialized billing expertise in psychotherapy services, telehealth coding, and psychiatric medication management. Our certified mental health billing specialists understand time-based CPT codes, crisis intervention billing, and HIPAA-compliant documentation requirements unique to behavioral health services.
Proven Results
32% Average Revenue Increase
96% First-Pass Claim Rate
50% Reduction in Denials
10 Days Faster Payment Collection
Common Billing Challenges
Time-Based CPT Code Accuracy
Psychotherapy and psychiatric services require precise time tracking with specific CPT codes based on session duration (30, 45, 60 minutes).
Telehealth Billing Complexities
Virtual mental health services have specific modifier requirements and varying state regulations for reimbursement.
Crisis Intervention Coding
Emergency psychiatric services and crisis intervention require specific CPT codes with detailed documentation of medical necessity.
Group vs Individual Session Billing
Different CPT codes and reimbursement rates for individual, family, and group therapy sessions require careful distinction.
Add-On Code Confusion
Psychotherapy with E/M services on the same day requires proper add-on code usage and medical necessity justification.
HIPAA-Sensitive Documentation
Mental health billing requires extra confidentiality measures while ensuring documentation supports medical necessity.
Our Solutions
Behavioral Health Billing Specialists
Our team includes certified coders with specialized training in psychiatric and psychological service billing.
Expert time-based CPT code selection
Accurate differentiation between therapy types
Knowledge of crisis intervention billing
Reduced coding errors and claim denials
Telehealth Expertise
Dedicated support for virtual mental health services with up-to-date knowledge of telehealth regulations and modifiers.
Proper modifier application for telehealth
State-specific compliance tracking
Audio-only vs video session coding
Maximized telehealth reimbursement
Time Tracking & Documentation Systems
Advanced systems help ensure accurate time tracking and proper CPT code selection based on session duration.
Automated time-based code recommendations
Session duration validation
Documentation completeness checks
Reduced underbilling from time discrepancies
HIPAA-Compliant Confidentiality Protocols
Extra security measures specific to mental health records while maintaining documentation necessary for billing.
Enhanced privacy protections for behavioral health
Secure handling of sensitive information
Compliant documentation practices
Audit-ready record keeping
Specialized Services
Psychotherapy Session Billing
Accurate coding for individual, family, and group therapy sessions with proper time-based CPT codes.
Individual therapy (90832-90834, 90837)
Family therapy (90846-90847)
Group therapy (90853)
Interactive complexity add-on (90785)
Psychiatric Evaluation & Management
Expert billing for diagnostic evaluations, medication management, and psychiatric consultations.
Diagnostic evaluations (90791-90792)
Medication management (90863)
Psychiatric consultation
Follow-up E/M services
Crisis Intervention Services
Specialized billing for emergency psychiatric services and crisis intervention with appropriate time documentation.
Crisis psychotherapy (90839-90840)
Emergency psychiatric services
First 60 minutes billing
Additional time increments
Telehealth & Virtual Care
Complete telehealth billing support with proper modifiers for synchronous and asynchronous services.
Telehealth modifier application
Audio-only services (modifier FQ)
Place of service codes
State regulation compliance
Common CPT Codes Reference
Key behavioral health CPT codes include 90832 (psychotherapy 16-37 minutes), 90834 (psychotherapy 38-52 minutes), 90837 (psychotherapy 53+ minutes), 90791 (psychiatric diagnostic evaluation), 90792 (diagnostic evaluation with medical services), 90853 (group psychotherapy), 90847 (family therapy with patient present), 90839 (crisis psychotherapy first 60 minutes), and add-on codes 90833/90836/90838 for psychotherapy with E/M services. Accurate time-based documentation is essential for proper code selection and reimbursement.
Expert Billing Insights
Time-Based Documentation: The Foundation of Behavioral Health Billing
Psychotherapy CPT codes are strictly time-based, requiring precise documentation of session start and stop times. The difference between billing 90832 (16-37 min) versus 90834 (38-52 min) can mean $40-60 per session, and practices that inadequately track time routinely undercode by 20-30%. Understanding the midpoint rule—where crossing the halfway threshold of a time range determines code selection—is critical for accurate billing.
Document exact start/stop times for every therapy session to support time-based code selection
90834 (38-52 min) is the most commonly billed therapy code; ensure sessions consistently meet the 38-minute threshold
Add-on codes 90833/90836/90838 require a separately billable E/M service on the same date
Undercoding from poor time documentation costs behavioral health practices 20-30% of potential revenue
Telehealth Billing for Mental Health: Navigating the Post-PHE Landscape
Post-COVID telehealth permanence has created a complex landscape for mental health billing. Modifier 95 is used for synchronous audio-video telehealth, while modifier 93 now enables audio-only billing for behavioral health services. Place of service codes differ between telehealth (POS 02 for facility, POS 10 for home) and can affect reimbursement rates by 10-15%. State licensure requirements add another layer of complexity for multi-state telehealth practices.
Use modifier 95 for synchronous audio-video sessions and modifier 93 for audio-only services
State licensure compacts (PSYPACT, ASWB mobility) enable multi-state practice but require proper credentialing
Medicare permanently covers mental health telehealth without geographic restrictions post-PHE
Medication Management and Split/Shared E/M Visits in Psychiatry
Psychiatrists frequently bill E/M codes with add-on psychotherapy codes (90833/90836/90838), creating documentation complexity. Split/shared visits between psychiatrists and supervised therapists require clear documentation of each provider's role and the substantive portion criteria. Collaborative care model codes (99492-99494) represent a growing revenue stream for practices integrating behavioral health with primary care, with monthly reimbursement of $140-170 per patient.
E/M + add-on therapy codes require separate documentation for each component
Split/shared visit rules require the billing provider to perform the substantive portion
Collaborative care codes (99492-99494) provide $140-170/month per enrolled patient
Incident-to billing for supervised therapists requires direct physician supervision and proper modifier usage
Payer-Specific Billing Tips
Medicare Part B
MIPPA eliminated the 50% coinsurance for outpatient mental health—standard 80/20 applies
LCD requirements for crisis intervention (90839/90840) require documented imminent risk
Psychological testing (96130-96131) requires medical necessity documentation and face-to-face time tracking
ABN required for non-covered services like marital therapy without an individual diagnosis
Medicare Advantage Plans
Prior authorization requirements for therapy beyond 20-30 sessions vary significantly by plan
Step therapy protocols for psychiatric medications may delay treatment initiation
Behavioral health carve-out networks (Optum, Beacon) may have separate credentialing requirements
Telehealth policies vary by MA plan—some restrict audio-only billing that traditional Medicare covers
Medicaid Programs
Session limits vary by state—some cap outpatient therapy at 20-30 visits per year
Rehabilitation H-codes (H0031, H2019) may be required instead of CPT codes in some states
Prior authorization for psychological testing can take 2-4 weeks
Medicaid MCOs may have different covered service lists than fee-for-service Medicaid
Commercial Payers (BCBS/UHC/Cigna)
Mental Health Parity Act requires commercial plans to cover behavioral health comparably to medical services
Out-of-network billing for specialized therapies (EMDR, DBT) may require superbill documentation
EAP sessions typically cover 3-8 visits before transitioning to insurance-billed services
Credentialing timelines for LCSWs and LMFTs average 90-120 days with commercial payers
Client Testimonial
As a psychiatry practice offering both in-person and telehealth services, billing accuracy
is critical. Medtransic's team understands the complexities of time-based psychotherapy codes,
telehealth modifiers, and medication management billing. They've increased our revenue by 35%
while maintaining the highest standards of patient confidentiality. Their expertise in
behavioral health billing is unmatched.