Psychiatric visits are paid for
Visit details are posted against the correct rendering provider, place of service and diagnosis. Before the claim leaves, a missing time note or a mismatched add-on is sent back to the clinician.
Invoicing for mental health practices Hero
Psychiatry bogs down on small issues, claims Add-on code with no time note NP visit coded to wrong provider Standalone carrier behavioral health benefit We get them before they get out and hunt down what gets through. Give the full cycle or just the tasks your team cannot get to.
Each practice runs differently. Before we finalize scope, we review your payer mix, your types of visits and where claims typically get held up.
Why psychiatry is different
Rare to have one code for a psychiatric visit. An E/M service can include a psychotherapy add-on, which is based on minutes: 90833 for 16 to 37 minutes, 90836 for 38 to 52 minutes, 90838 for 53 minutes or more.
Evaluations are split between 90791 and 90792 depending on whether medical services are provided. Medication management does not have its own code. It bills through E/M so the note has to justify the level you picked. Then you can add collaborative care codes 99492 to 99494, long-acting injectables or TMS sessions. Now the picture gets even more crowded. The problem depends on the size of practice.
Follow-up behind a solo psychiatrist. A group practice sees the 90-day balances pile up. A growing NP practice needs to figure out direct vs. incident to billing early. We figure out which ones are yours, and then we take over the pieces you give us.
Our Work
Select one, some, or the entire cycle. All get written into a scope so your staff knows what is ours and what stays with them.
Visit details are posted against the correct rendering provider, place of service and diagnosis. Before the claim leaves, a missing time note or a mismatched add-on is sent back to the clinician.
We audit 90791, 90792, E/M levels, and psychotherapy add-ons against the note itself. Where paper is thin on time or complexity we flag it.
We verify active coverage and then determine if mental health benefits are with a separate behavioral carrier. Visit limits, authorization rules, and copays are also recorded.
Claims are scrubbed, submitted and tracked. “If we get a rejection from the clearinghouse, we fix it and resubmit right away.”
The remittance advice is your source for all payments and adjustments. Underpayments/short pays are flagged for review.
Each denial is read for its actual reason code, then sent to a fix: resubmission, added records or a formal appeal.
We run the unpaid claims aging report, by payer, document every call or portal response and set the next step on the account.
Patients are billed after insurance processes, and statements show what was paid and what is still owed
Some practices want one team for the whole thing. “We can manage the whole revenue cycle from the first visit to the final payment.
Services we charge for
Coding rules are different for each visit type and for each payer. First we map your service mix, then we build the workflow.
This includes diagnostic evaluations, medication management visits, psychotherapy with and without an E/M service, injectable administration, and TMS or esketamine sessions (if your practice offers them). Payers don’t agree on either, so modifiers and place of service rules for telehealth visits get their own check.
Where claims get bogged down
Some payer decisions are sticky. A lot of problems begin within the practice and can be resolved there.
We verify that psychotherapy minutes are recorded separately from the E/M portion of the visit.
We identify the carrier that actually administers the mental health benefits prior to the patient’s first appointment.
We confirm each payer's rules for billing under NP or incident-to physician.
TMS, esketamine, and extended treatment often require approval first, so we track it by patient.
Read reason code, correct, document or appeal.
We review aging accounts by payer and establish a next step for each.
The start of the work
Rules are established before the first claim is touched, so no one has to wonder who owns what.
We review your payer mix, visit types, EHR, staffing and where billing gets stuck.
You submit a claims report when a business associate agreement is in place. We look at it and write down who owns which task.
We’ll connect to your EHR or billing platform and map your providers, locations and fee schedules.
Eligibility, charges, coding review and claim submission starts under agreed scope
Your remits are posted and a written next step is provided for each denied claim.
You receive reports by provider, payer, and CPT code. Open accounts are placed on a follow-up list.
Why Mental Health Billing ?
You get people who understand psychotherapy time rules, behavioral carve-out carriers, and a distinct line between what we do and what your staff retains. No pre-packaged bundle you didn't want.
Review your workflow →Before You Choose
If claims sit unworked, a biller leaves, visits grow faster than the staff can handle, or you only need an expert for a few tasks, outsourcing is a good idea.
It is a poor fit for some practices, and results vary by payer mix and documentation quality. Compare what each company covers, who can see your data, how you will be charged and whether they can work in your EHR. We’ll answer those questions directly, even if the answer is that you don’t need us yet.
Send us your questions →
Frequently Asked Questions
Quick answers to what practices ask before they hand off billing.
Based on the scope we perform eligibility verification, charge capture, coding review, claim submission, payment posting, denial management, accounts receivable follow-up and patient statements.
Yes. Mental Health Billing is built for psychiatrists, PMHNPs, and group practices that use both, and includes the provider level setup required by each payer.
Yes. There are lots of groups that outsource denials, A/R, or coding review, but do their front desk and charge work in-house.
We compare documented minutes for psychotherapy to the add-on billed (90833, 90836, or 90838) and confirm that time is documented separately from the E/M work. Gaps are returned to the provider before claim submission.
We read the reason for denial. We choose the fix: correction and resubmission, added records, reconsideration, or appeal. Medicare allows 120 days from the date of the initial determination to request a redetermination, and commercial payers have their own time frames. Some denials are unrecoverable.
Yes, most of the time. We will confirm system access and workflow during the intake call before finalizing any scope.
No, no billing company has that power, it’s up to the payers to decide coverage and payment. We control the accuracy of claim preparation and the persistence with which they are pursued.
A good rundown of your practice, main payers, billing software, and trouble spots. Do not include patient names or clinical information in the contact form.
Start
How does billing run today, where does it break down, do you want the whole cycle covered or one task. We'll tell you straight if we're a good fit.
Contact our billing department