Specialty billing
Behavioral and Mental Health Billing Without the Authorization Scramble
Time-based psychotherapy coding, telehealth rules and the authorization cadence therapy payers impose.
The challenge
What makes behavioral health billing different
Behavioral health billing is governed by time in a way most of medicine is not. Psychotherapy codes are defined by session length, and a session that runs short or long moves to a different code entirely. The documented duration is not a detail on the claim — it is the claim.
The other constant is authorization. Many behavioral health plans authorize a set number of sessions at a time and require a fresh request before the next block, which means a clinician can deliver several sessions inside an expired authorization without anyone noticing until the denials arrive weeks later.
Why us
Why behavioral health practices work with us
Specialty billing is not a marketing label for us. Coders and A/R staff are assigned by specialty, so the person on your account reads notes like yours every day.
Get a free assessment- Session duration checked against the code billed on every claim
- Authorization blocks tracked with alerts before the last approved session is used
- Telehealth place of service and modifier rules kept current per payer
- Out-of-network reimbursement pursued properly for practices that stay non-participating
Scope of work
What we handle for behavioral health practices
The work below is specific to this specialty, not a generic billing checklist with the name swapped out.
Time-based psychotherapy coding
Session codes selected against documented start and stop times or total duration.
Therapy with evaluation and management
Psychotherapy add-on services billed alongside E/M where both are separately documented.
Telehealth billing
Place of service and modifier requirements maintained per payer as telehealth policies change.
Session authorization tracking
Authorized session counts monitored with re-authorization requested before the block runs out.
Group and family therapy
Group, family and collateral sessions coded to the correct format and participant structure.
Psychological testing
Testing, evaluation and scoring services billed to the correct administration and interpretation units.
The Right Way difference
What we watch on behavioral health claims
These are the details that separate a paid claim from an appealed one in behavioral health. They are checked on every claim, not sampled.
- 01 Documented session duration, which determines the code and is the first thing an auditor checks
- 02 Whether psychotherapy and an E/M service on the same day are both separately documented
- 03 Remaining authorized sessions, tracked so care does not continue into an expired block
- 04 Telehealth modifier and place of service requirements, which continue to differ between payers
- 05 Parity considerations where a plan applies limits to behavioral care it does not apply elsewhere
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Years running revenue cycles for physician practices
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Providers billed for across every specialty we serve
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First-pass clean claim rate
0 days
Median days in accounts receivable
Questions
Behavioral & Mental Health billing questions
What practices in this specialty ask us most often before making a change.
Ask us something elseIt depends on your market, your caseload and how much administrative work you want. We can model both, and if you stay out of network we handle the reimbursement pursuit properly rather than leaving it to patients.
We maintain payer-level telehealth requirements as part of ongoing account management, because place of service and modifier expectations have kept shifting. Getting this wrong produces a denial pattern that can run for weeks before it is spotted.
That is exactly what the authorization tracking is for. We monitor remaining approved sessions per patient and flag re-authorization before the block is exhausted, rather than discovering it on a remittance.
How it works
Getting started takes about a month
The same four steps whichever specialty you are in. No system migration and no gap in your cash flow.
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01
Revenue assessment
We audit a sample of your claims, denials and aged A/R and show you what we found. Free, and yours to keep either way.
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02
Scope and agreement
A written scope covering exactly which services we run, what it costs and what we are accountable for.
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03
Access and onboarding
We set up inside your existing EHR and clearinghouse. Two to four weeks, run in parallel with your current process.
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04
Live and reporting
We take over submission and follow-up, and you get monthly reporting you can actually act on.
Free consultation
Let us look at your behavioral health claims
Send us a sample and we will tell you specifically what is being coded, denied or under-paid — and what it is worth to fix. Free, and yours to keep.