Behavioural Health Billing Services

What Is Behavioural Health Billing?

Behavioural Health Services We Bill

• Psychiatry & Psychological Evaluations We manage billing for initial psychiatric diagnostic evaluations, psychological testing, medication management visits, and follow-up appointments across all provider types psychiatrists, psychologists, and psychiatric nurse practitioners.
• Individual Psychotherapy We accurately apply time-based psychotherapy codes based on documented session length ensuring the right code is used every time and that all documentation requirements are met to support the claim.
• Group & Family Therapy We handle billing for group therapy sessions and family psychotherapy services, including correct application of add-on codes and interactive complexity modifiers where appropriate.
• Substance Use Disorder (SUD) Treatment We bill for a full range of addiction treatment services from alcohol and drug assessments to intensive outpatient programs (IOP), detox services, and medication-assisted treatment (MAT). We navigate both commercial insurance and Medicaid billing for SUD-specific services.
• Crisis Intervention Services We manage billing for crisis psychotherapy, crisis stabilization, and emergency mental health services, applying the correct codes and time documentation standards.
• Collaborative Care Management (CoCM) We handle billing for integrated behavioural health programs, including General Behavioral Health Integration (BHI) and Psychiatric Collaborative Care Management (CoCM) codes a growing area of reimbursement that many practices underutilize.
• Telehealth Mental Health Services We apply proper place-of-service codes and telehealth modifiers to ensure your virtual therapy sessions are billed correctly and reimbursed at the right rates across Medicare, Medicaid, and commercial plans.

Key CPT Codes for Behavioural Health

• 90791 – Psychiatric diagnostic evaluation (without medical services)
• 90792 – Psychiatric diagnostic evaluation (with medical services)

• 90832 – Individual psychotherapy, 16–37 minutes
• 90834 – Individual psychotherapy, 38–52 minutes
• 90837 – Individual psychotherapy, 53+ minutes

• 90853 – Group psychotherapy
• 90846 – Family psychotherapy without patient present
• 90847 – Family psychotherapy with patient present

• 90839 – Psychotherapy for crisis, first 60 minutes
• 90840 – Each additional 30 minutes (add-on)

• H0001 – Alcohol and/or drug assessment
• 99408 – Substance abuse screening and brief intervention, 15–30 minutes
• H0020 – Alcohol and/or drug services; methadone administration

• 99484 – General BHI care management, per calendar month
• 99492 – Initial psychiatric collaborative care management, first 70 minutes
• 99493 – Subsequent psychiatric collaborative care management, first 60 minutes

Why Behavioural Health Billing Is Especially Challenging

• Time-based coding is unforgiving. Psychotherapy codes like 90834 and 90837 are separated by just one minute (52 vs. 53 minutes). Billing the wrong code even slightly creates compliance risks and denial exposure.
• Documentation requirements are strict. Every claim must be supported by detailed clinical notes that establish medical necessity, reflect the actual service provided, and include start and end times for timed services. Incomplete documentation is one of the leading causes of behavioural health claim denials and post-payment recoupments.
• Payer rules vary widely. A modifier sequence that works for a commercial plan may not work for Medicaid. Each payer has its own prior authorization thresholds, session limits, and documentation standards. Navigating these variations requires genuine specialty expertise.
• Mental Health Parity adds a compliance layer. Under MHPAEA, insurers must cover mental health and SUD services comparably to medical/surgical services. Our team identifies and challenges parity violations when payers apply stricter rules to behavioural health claims than they do to comparable medical services.
• Carve-out administrators create complexity. Many commercial insurers outsource their behavioural health benefits to third-party administrators like Optum, Beacon Health, or Magellan. Each has its own portal, documentation standards, and clinical review processes all of which our team handles on your behalf.

What MedFeeTree Manages For You

• Benefits verification & prior authorization - We confirm coverage and obtain approvals before sessions begin, eliminating billing surprises
• Accurate time-based CPT coding - We match each claim to the correct psychotherapy code based on documented session length and service type
• ICD-10 diagnosis coding -We ensure every claim is paired with the appropriate diagnosis codes that establish medical necessity
• Modifier management - We apply correct modifiers for telehealth, interactive complexity, provider type, and payer-specific requirements
• Clean claim submission -We submit complete, accurate claims the first time to reduce denials and speed up payment
• Denial management & appeals -We identify denial reasons, correct errors, and file appeals with supporting clinical documentation
• Medicaid & Medicare billing - We manage state-specific Medicaid behavioural health billing and Medicare compliance for all eligible provider types
• Credentialing support -We help behavioural health providers get credentialed with insurance networks to expand patient access and reimbursement eligibility
• Revenue cycle reporting - You receive clear, regular reports on claim status, reimbursement rates, and revenue performance.

Provider Types We Support

• Psychiatrists & Psychiatric Nurse Practitioners (PMHNPs)
• Psychologists (PhDs & PsyDs)
• Licensed Clinical Social Workers (LCSWs)
• Licensed Professional Counselors (LPCs)
• Marriage & Family Therapists (LMFTs)
• Addiction Counselors & Substance Use Disorder Specialists
• Crisis Intervention Teams
• Community Mental Health Centers
• Partial Hospitalization Programs (PHPs) & Intensive Outpatient Programs (IOPs)
• Multi-provider group behavioral health practices

Why Behavioural Health Providers Choose MedFeeTree

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