Psychology bills nothing like the rest of medicine, and the part of it that strays furthest from the standard playbook is the very work doctoral clinicians train hardest to perform: assessment. Testing codes that tier by the half hour and split the labor between technician and psychologist. Evaluation time that has to be measured to the minute rather than guessed at. Prior authorizations bolted onto nearly every battery a payer will reimburse. Carve-out plans that lift behavioral health out of the medical network the moment you look away. The money is genuinely there for PhD and PsyD practices but it surfaces only for the ones that code the fine grain instead of rounding straight past it. We live in that fine grain. From the first benefit check on a referral to the last dollar reconciled against your contract, our team shoulders the entire billing operation, so your clinicians spend their hours on patients and reports instead of payer portals and hold music.
Set a neuropsychological evaluation in front of a general medical biller and the revenue starts leaking before the claim ever clears the building. A technician spent two hours administering the battery, yet it goes out under 96136 the provider-administered code when it should have read 96138, and the payer either reverses the payment weeks later or rejects it on the spot. The additional-hour units evaporate because no one counted the time past the first sixty minutes. Your interpretive work the clinical judgment, the integration of findings, the written report gets quietly absorbed into the administration line, as though reading a profile of cognitive deficits were the same exertion as handing someone a pencil. None of these slips looks catastrophic in isolation. Stack twelve months of them together, though, and the shortfall on your year-end statement is impossible to overlook.
Psychology billing lives precisely in these distinctions: the wall between data collection and data interpretation, the supervision rules that decide whose NPI a technician’s units belong to, the parity protections payers are forever misplacing, the managed behavioral health plans that carve mental health clean out of the medical contract. That is the entire reason we exist. For more than fifteen years, our certified coders have worked inside behavioral health and nowhere near orthopedics or dermatology, which means we already know the question a payer will raise about your testing claim before it ever lands in your inbox. You will not be handed a template scraped off some cardiology account and relabeled. We build a psychology billing system around the way you actually practice your assessment volume, your therapy modalities, your supervisory structure, your payer mix, and the way your reports and notes are genuinely written a system shaped to your practice rather than one that demands your practice contort to fit it.
Every stage of the revenue cycle, owned outright and accounted for from the moment a testing referral arrives to the day the final balance posts.
Assessment is where doctoral practices earn the most and forfeit the most, frequently on the very same claim. We code it the way it is actually built: separating the evaluation and interpretation hours that only you can bill (96130–96131 for psychological work, 96132–96133 for neuropsychological) from the administration and scoring time that may be delegated to a technician under your supervision (96138–96139) or performed by you directly (96136–96137).
The initial evaluation sets both the clinical and the financial tone for everything that follows. We bill the psychiatric diagnostic evaluation (90791) cleanly, keep it distinct from the medical-service variant that does not apply to most psychologists, append the interactive complexity add-on (90785) only where the encounter genuinely earns it, and pair each intake with the exact ICD-10 F-code so the claim reads as a coherent clinical narrative rather than a guess a reviewer has to untangle.
Time is the hinge the entire code turns on. A fifty-minute session is not a thirty-eight-minute session, and a payer will hold you to the difference down to the digit. We bill individual psychotherapy at the correct tier (90832, 90834, 90837), handle family work with and without the patient present (90846, 90847), capture group sessions (90853) and crisis intervention (90839, 90840), apply interactive complexity where it truly belongs, and verify session and unit caps before a routine visit curdles into an avoidable denial.
When you treat the psychological dimension of a physical illness chronic pain, diabetes self-management, cardiac recovery the diagnosis driving the claim is medical, not mental, and the coding shifts accordingly. We bill the health behavior assessment (96156) alongside the individual, group, and family intervention codes (96158–96159, 96164–96165, 96167–96168, 96170–96171) against the correct medical diagnosis, so this frequently overlooked and chronically under-reimbursed line of work finally gets paid as the clinical service it actually is.
Virtual sessions and remote testing reimburse well when they are coded with discipline and vanish when they are not. We apply the right place-of-service codes and modifier 95, follow each carrier's evolving telehealth policy, and keep pace with the testing-specific telehealth allowances currently extended through the end of 2026 so your remote work is paid like the legitimate clinical labor it is rather than written off as a technicality.
Before a single test is administered, we confirm active coverage, behavioral health benefits, the separate testing benefit that so often hides in its own corner of the plan, deductible and coinsurance status, visit and unit limits, and whether a carve-out is lurking behind the medical card. The expensive surprises are the ones discovered after the work is finished; we move them to before the appointment, where they cost almost nothing to resolve.
Few things stall a doctoral practice like a battery waiting on approval. Most payers gate psychological and neuropsychological testing behind prior authorization, and we manage the full arc of it the initial request with medical-necessity documentation and estimated units attached, the concurrent reviews, the peer-to-peer when a reviewer pushes back so medically necessary assessment is never left marooned in an approval queue.
Nothing leaves our system unexamined. We scrub every claim for the specific errors that sink psychology billing unit miscounts, provider-versus-technician code conflicts, absent modifiers, diagnoses that do not match the service then transmit electronically to commercial plans, Medicare, Medicaid, TRICARE, and managed behavioral health organizations such as Optum, Carelon, and Magellan, lifting your first-pass acceptance rate and compressing the wait for payment.
A denial is a question with a findable answer, not a closed door. We trace each rejected claim back to its origin an exhausted authorization, a unit overage, soft medical-necessity language, a technician's units billed under the wrong code assemble an appeal anchored in the clinical record, then resubmit and pursue it until the money you already earned finds its way back to you.
We collect and verify complete demographics, insurance details, referral notes, and authorization requirements at the very outset laying a clean foundation before any service is rendered and intercepting the front-end mistakes that quietly sink claims weeks down the line.
For every patient, every time, we confirm coverage, mental health parity benefits, the distinct testing benefit, deductibles, coinsurance, session and unit limits, and authorization rules so the care your providers deliver is care you can actually bill and dependably collect on.
Our certified coders read the clinical record itself, not merely a superbill, translating each session and battery into exact CPT, ICD-10-CM, and HCPCS codes with the appropriate modifiers and confirming the documentation genuinely supports every unit submitted.
We send scrubbed, compliant claims to every payer, watch their status in real time, and stay on whatever sits pending, delayed, or denied chasing the fastest reimbursement your contracts permit instead of waiting for checks to drift in whenever they please.
We post all insurance and patient payments accurately, reconcile ERAs and EOBs, resolve underpayments and discrepancies, and deliver financial reporting clear enough to keep your accounts balanced and current month after month without the guesswork.
Every billable encounter is documented and captured each therapy session, each diagnostic evaluation, each hour and half-hour of testing, every add-on unit from a single intake to a full-day neuropsychological battery, so no legitimate revenue slides off the ledger unnoticed.
We file clean claims quickly, then refuse to let them sit idle. Pending, delayed, denied across Medicare, Medicaid, commercial carriers, and behavioral health carve-outs our team keeps steady pressure on each one until it resolves.
We read the denial patterns peculiar to your payer mix, build appeals with the clinical evidence attached, and claw back dollars that would otherwise be written off while repairing the upstream process so the same denial stops recurring.
Prior authorizations for testing, continued-care reviews, real-time eligibility checks, benefit confirmations we own all of it, clearing away the denials that otherwise only announce themselves after the work has already been delivered.
Our certified billing specialists track CMS rules, state Medicaid behavioral health policy, and shifting commercial payer requirements as they move keeping your practice compliant, protected, and ready for an audit on any given day.
Transparent performance reports, real-time AR dashboards, denial-trend breakdowns, collection-rate tracking we put the numbers in front of practice owners so they can make confident decisions and grow on intention rather than guesswork.
Choosing us means working with a team that genuinely grasps what sets psychology billing apart from the rest of healthcare and that fights for every dollar your practice has rightfully earned.