Behavioral Health Billing Excellence
Mental health billing requires specialized knowledge of therapy codes, prior authorization requirements, and the unique documentation standards that support behavioral health reimbursement.
Behavioral Health Billing Obstacles
Therapy Session Duration Mismatches
Mental health CPT codes have strict time requirements—90837 requires 53+ minutes while 90834 covers 38-52 minutes. Billing the wrong code based on actual session time versus documented time creates audit risks and systematic underpayment issues.
Group Therapy Billing Complications
Group therapy sessions (90853) require specific patient counts and participation documentation. Missing group notes, incorrect billing when family members attend, or confusion about who qualifies as a 'participant' leads to frequent claim denials.
Prior Authorization Maze
Behavioral health services face increasingly complex prior authorization requirements. Many payers require treatment plans, medical necessity documentation, and periodic reviews. Missing authorization renewals or inadequate clinical justification results in denied high-value claims.
Credentialing and Network Issues
Mental health provider credentialing involves additional licensing verifications and malpractice requirements. Out-of-network billing complications, sliding fee scale documentation, and coordination with Employee Assistance Programs create payment delays and denials.
Our Behavioral Health Billing Strategy
- We maintain expertise in behavioral health's unique billing requirements, including time-based therapy codes, group session protocols, and the complex prior authorization landscape that mental health providers navigate daily.
- Our team understands the clinical documentation requirements that support medical necessity for therapy sessions, ensuring treatment plans and progress notes align with billing to prevent audit vulnerabilities.
- We implement systematic prior authorization tracking for behavioral health services, monitoring approval periods and renewal requirements to prevent disruption in ongoing patient care and revenue flow.
- Our credentialing specialists handle the additional complexities of mental health provider enrollment, including state licensing verification and specialized network participation requirements.
Mental Health Billing Results
Optimize Your Mental Health Practice Revenue
Let our behavioral health billing specialists handle your complex mental health reimbursement while you focus on patient therapeutic outcomes.