Time-Based Code Documentation
Therapy codes like 90834 and 90837 hinge on session duration. If documentation does not clearly support the billed time, payers deny or downcode the claim after audit.
MH Practices Served
Clean Claim Rate
Revenue Recovered
Claim Submission
Mental health billing carries a unique set of obstacles that general billing teams rarely understand. Time-based therapy codes demand precise documentation. Payer networks split behavioral and medical benefits into separate systems. And authorization requirements shift from plan to plan without warning.
We work with mental health practices to build billing processes that protect revenue without adding clinical burden. From code selection to denial appeals, our team handles every step so therapists and psychiatrists can focus on patient care.
Every Mental Health billing team deals with payer delays, coding nuance, and collection leakage. We tighten those weak points before they turn into write-offs.
Therapy codes like 90834 and 90837 hinge on session duration. If documentation does not clearly support the billed time, payers deny or downcode the claim after audit.
Mental health benefits are frequently managed by a separate behavioral health administrator, even within commercial plans. Claims routed to the medical side get rejected automatically.
Mental health providers face longer credentialing timelines than most specialties. Until credentialing is complete, claims cannot be submitted, and revenue stalls.
Diagnosis codes for mental health carry social weight. Providers must balance clinical accuracy with patient concerns about diagnostic labels appearing on insurance records.
Support spans the full revenue cycle, from front-end verification to denial recovery and reporting.
Therapy session coding (individual, group, family, crisis)
Psychiatric evaluation and medication management billing
Payer benefit verification and carve-out identification
Authorization tracking with automated renewal alerts
Credentialing and network enrollment for new providers
Denial appeals with clinical documentation support
We support independent practices, multisite groups, and growing provider organizations with flexible workflows.
Independent physician groups
Multi-location practices
Private equity backed platforms
Hospital-owned outpatient groups
Mental health billing carries a unique set of obstacles that general billing teams rarely understand. Time-based therapy codes demand precise documentation. Payer networks split behavioral and medical benefits into separate systems. And authorization requirements shift from plan to plan without warning.
We work with mental health practices to build billing processes that protect revenue without adding clinical burden. From code selection to denial appeals, our team handles every step so therapists and psychiatrists can focus on patient care.
Answers to the questions practice owners and managers ask most often before switching billing partners.
CPT 90834 covers a 38 to 52-minute therapy session, while 90837 covers sessions of 53 minutes or longer. The distinction matters because payers audit time-based codes closely and will downcode 90837 to 90834 if documentation does not support the longer duration.
Reimbursement varies significantly. Medicare typically pays $80 to $110 for a 90837 session, while commercial payers range from $90 to $180 depending on the network contract and geographic region.
Yes. Telehealth mental health billing requires the correct place of service code (02 or 10 depending on the payer), appropriate modifiers (95 or GT), and documentation confirming the patient consented to the telehealth visit.
We monitor authorization windows and initiate renewal requests before expiration. If a gap occurs, we work with the payer to obtain retroactive authorization when clinically justified, using supporting documentation from the treating provider.
Yes. Psychiatric NPs bill under their own NPI in most states, using the same CPT codes as psychiatrists. Some payers apply different fee schedules for NPs, which we account for during claim submission.
While we do not manage scheduling, we ensure that cancelled and no-show appointments are flagged so practices can enforce their financial policies. We also optimize the billing cycle so that completed sessions are submitted within 24 hours.
The difference is operational discipline. We focus on clean submissions, fast follow-up, and transparency.
Get a revenue review and a clear action plan tailored to your practice, payers, and claim mix.