Carved-out benefits
Many medical plans route mental health claims to a separate behavioral health organization with its own eligibility, authorization and claims address.
Behavioral health revenue cycle
Behavioral and Mental Health Billing Services
Mental health claims fail for reasons that rarely affect other specialties: carved-out behavioral health plans, time-based psychotherapy codes, provider-type rules, visit limits and telehealth details. We set up billing around those rules.
In short
Behavioral health billing covers the steps between a session and payment: checking mental health benefits (often managed by a separate behavioral health plan), credentialing each clinician, coding psychotherapy and evaluation services by time and provider type, submitting claims, and following up on denials. Global Tech Billing handles these steps for independent mental health practices.
Billing challenges for behavioral health
Credentialing gaps
Each clinician must be enrolled with each payer before claims pay. Group and individual enrollment, CAQH and Medicare rules for newer provider types all need tracking.
Time-based coding
Psychotherapy codes depend on documented face-to-face time, and add-on codes depend on what else was billed that day.
Telehealth details
Place-of-service codes, modifiers and audio-only rules differ by payer and must match where the patient was during the visit.
How the work moves
Our behavioral health billing workflow
- 1
Benefits check
Confirm the plan that manages mental health benefits, network status, copay, deductible, authorization and visit limits.
- 2
Encounter review
Match rendering provider, service, time, location and telehealth details to the claim.
- 3
Clean submission
Scrub claims against payer rules and track acknowledgements from the clearinghouse and payer.
- 4
Payments and denials
Post payments, set patient responsibility and work denials within appeal limits.
Common behavioral health codes we work with
These are the code families most mental health claims use. Final code selection always belongs to the treating clinician and must match the documentation.
| Code | What it covers | Billing note |
|---|---|---|
| 90791 / 90792 | Psychiatric diagnostic evaluation | 90792 includes medical services and is used by physicians and other prescribers; 90791 does not. |
| 90832, 90834, 90837 | Psychotherapy (30, 45, 60 minutes) | Chosen by documented time with the patient and/or family. |
| 90833, 90836, 90838 | Psychotherapy add-ons with E/M | Reported with an E/M service when a prescriber also provides psychotherapy. |
| 90846 / 90847 | Family psychotherapy | Without or with the patient present. |
| 90853 | Group psychotherapy | Billed per patient in the group. |
| 90839 / 90840 | Psychotherapy for crisis | First 60 minutes, then each additional 30 minutes. |
Payer policies on add-on codes, session limits and telehealth change. Check current CPT guidance and the patient's plan before submitting.
Credentialing for behavioral health providers
- Commercial and Medicaid managed-care enrollment, including behavioral health organizations that manage carved-out benefits.
- Medicare enrollment for psychiatrists, psychologists, clinical social workers, PMHNPs, and marriage and family therapists and mental health counselors (eligible since January 1, 2024).
- CAQH profile setup, document uploads and quarterly re-attestation.
- Group setup, reassignment and adding new clinicians to existing contracts.
Common denial reasons we work
Eligibility or wrong payer
Claim sent to the medical plan instead of the behavioral health administrator.
Provider not enrolled
Rendering clinician not credentialed or not linked to the group.
Authorization or visit limits
Sessions beyond an authorized number or plan limit.
Coding and time
Time documented does not support the code, or add-on billed without the base service.
How onboarding works
- Step 1
Consultation about your payers, systems, volume and the problems you want solved.
- Step 2
Review of recent claims, denials and aging A/R to set a baseline.
- Step 3
Written scope and price, and a signed Business Associate Agreement.
- Step 4
Access set up in your EHR, practice-management system and clearinghouse.
- Step 5
Go-live on an agreed date, with open claims and old A/R worked in parallel.
Work is delivered remotely by our Fresno, California-based company, inside the systems your practice already uses. We sign a Business Associate Agreement (BAA) with every client before we access any protected health information (PHI). How our team works.
Behavioral Health billing guides
Related specialties
- Medical Billing for Therapists
Billing for counselors, LCSWs, LMFTs, psychologists and group therapy practices.
- Psychiatry and PMHNP Billing
E/M with psychotherapy add-ons, evaluations, telehealth and medication management.
- Nurse Practitioner Billing
Billing and credentialing for NPs, PMHNPs and NP-owned practices.
- ABA Billing and Authorization Management
Authorization-sensitive billing for applied behavior analysis providers.
Authoritative references
- APA: CPT Coding Overview
American Psychiatric Association coding and reimbursement resources.
- CMS MLN: Medicare & Mental Health Coverage
Medicare coverage, eligible practitioners and telehealth for mental health services.
- CMS MLN: Telehealth & Remote Monitoring
Current Medicare telehealth billing guidance.
Behavioral Health billing FAQs
What does a mental health billing company do?
It verifies behavioral health benefits, credentials clinicians with payers, submits psychotherapy and evaluation claims, posts payments, works denials and follows up on unpaid balances, so clinicians can focus on sessions.
Do you work with therapists, psychiatrists and PMHNPs?
Yes. We support solo therapists and counselors, group therapy practices, psychiatrists, psychiatric nurse practitioners and ABA providers, each with the codes and credentialing steps that apply to them.
Can you handle credentialing as well as billing?
Yes. We enroll clinicians with Medicare, Medicaid, managed-care and commercial payers, maintain CAQH profiles and add new clinicians to group contracts.
Do you bill telehealth sessions?
Yes. We apply the place-of-service code and modifier each payer requires for video or audio-only sessions, based on where the patient was and what was documented.
How is patient information protected?
We sign a Business Associate Agreement with every client before accessing any protected health information, and work inside your own EHR and billing systems.
Ready to review your behavioral health billing?
Share your payers, systems and current bottlenecks, and we will tell you where the biggest gaps are.
Request a ConsultationPage reviewed October 22, 2026. Educational information only; apply current CPT and HCPCS guidance, payer contracts, coverage policies and compliance requirements to each claim.