Medicaid is the single largest payer of mental health and substance use treatment in the United States, according to an August 2025 Milbank Quarterly opinion piece by Emma McGinty and Magdalena
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A therapist who sees 25 clients a week files roughly 1,300 claims a year. Multiply that across a five-clinician group and the practice is reconciling more than 6,000 payment decisions annually,
Read MoreFor decades, the list of clinicians who could bill Medicare for mental health services was short and stable: physicians, clinical psychologists, clinical social workers, and a handful of advanced practice clinicians.
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Front desk staff hear a version of this question several times a shift: “I think I have insurance, but I’m not sure who it’s with.” Sometimes the patient lost their card.
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If you work in medical billing, coding, or clinical administration, you’ve almost certainly come across CPT code 99211 either because you use it regularly or because you’ve had a claim denied
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