Provider type not eligible for the service
Some plans do not pay certain license types, or require supervision and billing under another provider.
How we prevent it: We credential each provider for the services they can bill with every payer.
PSYCHIATRIC BILLING
Psychiatric Billing Services
Behavioral health billing involves time-based psychotherapy codes, add-on codes with E/M, telehealth rules and payer-specific mental health benefits.
No upfront feesHIPAA-compliantSpecialty-trained coders
$0
Upfront or setup fees
0
Revenue cycle steps managed end to end
0
Specialties and lab types we bill for
0
Of your data and systems stay yours
OVERVIEW
Psychiatric billing done right
Behavioral health billing involves time-based psychotherapy codes, add-on codes with E/M visits and payer rules that vary by provider type. A psychiatrist, psychiatric nurse practitioner, psychologist and licensed counselor may each be paid differently for the same service.
Many health plans carve behavioral health out to separate managed behavioral health organizations, with their own enrollment, authorization and session limits. Telehealth adds place of service and modifier rules that differ by payer.
We bill psychiatric and therapy practices with these rules in mind: coding psychotherapy by documented time, pairing add-on codes correctly, credentialing every provider type and tracking session authorizations.
Also see our medical coding, denial management, eligibility verification and revenue cycle management services.
CODING
Common psychiatric CPT & HCPCS codes we bill
Behavioral health coding depends on time, who provides the service and whether an E/M visit is included.
| Code | Description | What we watch for |
|---|---|---|
| 90791 | Psychiatric diagnostic evaluation | Use 90792 when the evaluation includes medical services by a prescriber. |
| 90792 | Psychiatric diagnostic evaluation with medical services | Only billable by providers who can perform medical services. |
| 90832 | Psychotherapy, 30 minutes | Requires 16–37 minutes of face-to-face psychotherapy. |
| 90834 | Psychotherapy, 45 minutes | Requires 38–52 minutes of psychotherapy time. |
| 90837 | Psychotherapy, 60 minutes | Requires 53 minutes or more; some payers review frequent use. |
| 90833 | Psychotherapy, 30 minutes, with an E/M service (add-on) | Reported with an E/M code; therapy time must be separate from E/M time. |
| 90847 | Family psychotherapy with the patient present, 50 minutes | Use 90846 when the patient is not present. |
| 90853 | Group psychotherapy | Billed per patient in the group, not per session. |
| 90785 | Interactive complexity (add-on) | Only with specific psychiatric codes, when communication factors are documented. |
| 99214 | Established patient office visit, moderate complexity | Common for medication management visits. |
Code descriptions are summarized. CPT® is a registered trademark of the American Medical Association. Coverage and payment rules vary by payer and change every year; we code to the current code set and your payers’ policies.
Modifiers that matter in psychiatric billing
95
Synchronous telehealthUsed by many payers for audio-video visits, with POS 02 or 10.
93
Audio-only telehealthFor audio-only services where the payer allows them.
AJ
Clinical social workerRequired by Medicare on services by licensed clinical social workers.
AH
Clinical psychologistIdentifies services by a clinical psychologist for some payers.
HO / HN
Education level modifiersSome Medicaid programs require modifiers that show the provider’s degree.
DENIALS
Why psychiatric claims get denied
The denial reasons we see most often in psychiatric billing, with the claim adjustment reason code (CARC) payers usually attach, and what we do so they don't happen again.
Missing session authorization
Behavioral health organizations often authorize a set number of sessions.
How we prevent it: We track authorized sessions and request more before they run out.
Benefit maximum reached
Plans with visit limits deny sessions after the limit.
How we prevent it: We check remaining benefits and notify you before a patient reaches the limit.
Place of service inconsistent
Telehealth billed with the wrong POS or modifier is denied or paid at the wrong rate.
How we prevent it: We apply each payer’s telehealth POS and modifier rules.
Psychotherapy add-on without an E/M
Add-on codes 90833, 90836 and 90838 are denied without a qualifying E/M.
How we prevent it: Our edits require the primary E/M on the same claim.
HOW WE WORK
How we run your psychiatric revenue cycle
From the first eligibility check to the final patient payment, one dedicated team handles every step and reports back to you.
01
Eligibility and authorization
We verify coverage, benefits, copays and deductibles before the visit. For behavioral health, that includes checking carve-outs and session authorizations.
02
Charge capture and coding
Our coders review documentation and assign CPT, HCPCS and ICD-10-CM codes to the highest supported specificity. Psychotherapy is coded by documented start and stop times and session type.
03
Claim scrubbing and submission
Every claim is checked against NCCI edits, payer policies and modifier rules before it goes out electronically, so it is paid on the first pass.
04
Payment posting and reconciliation
We post ERAs and EOBs, compare payments to your contracted rates and flag underpayments for appeal.
05
Denial management and A/R follow-up
Every denial is worked: corrected, appealed or escalated, with root causes fed back to the front end. Credentialing and authorization denials are corrected and resubmitted quickly.
06
Reporting and patient billing
You get clear monthly reports on collections, denials and A/R aging, and patients get easy-to-read statements and answers to billing questions.
COMPLIANCE
Psychiatric payer rules we track for you
Rules that change how psychiatric claims must be coded, documented and submitted.
Time thresholds: psychotherapy codes use set minute ranges, and time must be documented.
Add-on rules: psychotherapy with E/M requires separate, documented time for therapy.
Carve-outs: behavioral health benefits may be managed by a different company than medical benefits.
Telehealth: payers differ on POS, modifiers 95 and 93, and audio-only coverage.
FAQ
Psychiatric billing questions
Do you bill for therapists and psychiatrists in the same group?
Yes. We bill each provider under their license type and credential them with each payer.
Can you bill telehealth sessions?
Yes. We apply the right place of service and modifiers for each payer’s telehealth policy.
How do you protect patient privacy?
We use HIPAA-compliant workflows and limit access to the minimum information needed, with extra care for psychotherapy notes.
How much do your psychiatric billing services cost?
We charge just 2.25%–2.75% of what we actually collect for you, with no upfront or setup fees. Your exact rate within that range depends on claim volume and the services you need, and we confirm it after a free review of your current billing.
Do we have to change our EHR or practice management system?
No. We work inside the systems you already use, and your data stays yours. We set up secure access, learn your workflows and start working claims without disrupting your front desk.
Related specialties
FREE PSYCHIATRIC BILLING REVIEW
Get Paid
Send us a sample of your psychiatric denials and A/R. We'll show you where revenue is slipping and how we'd fix it, with no obligation and no upfront fees.