What Do You Need To Know About Mental Health Billing Services

A mental health billing service is a specialized medical billing service that can help you get paid faster and with less hassle. Mental health providers need to be able to submit claims quickly. If you’re looking for a professional solution that will help you streamline your practice while generating more revenue, look no further. This guide will help you to understand the mental health billing process.

What Is Mental Health Billing?

Mental health billing is the contribution and monitoring of claims for services rendered to patients with mental or behavioral health diagnoses. It’s not the same as medical billing, which involves filling out forms and sending them to insurance companies or third parties. 

The existence of mental health services adds another layer of difficulty to billing and receiving payment, and mental health billing is generally more complex than medical billing. This enhanced difficulty is mainly due to service variation not discovered in primary or specialty care. Insurance companies have different rules about what they will cover based on factors such as session length, frequency, treatment maximum values, and more. Mental health billing services can help you submit claims for reimbursement from insurance companies and other third parties. Private professionals know how to manage the complex paperwork involved in getting paid to run mental health billing services. They will also guide you through any potential issues that may arise when submitting claims for clients who need help getting reimbursed by an insurance company or other third party.

Different Kinds of Mental Health Billing

There are four major mental health billing classifications. Each of these groups has its CPT (Current Procedural Terminology) codes.

Psychotherapy Billing

Psychotherapy billing can be complex because of the complicated and unique nature of what patients require. There may be extra factors to consider when billing, whether mental health sessions have multiple facets or the patient is enrolled in a residential program. Timing, testing, evaluation, crisis codes, and any other add-ons must all be considered by therapists for proper coding of their psychotherapy services.

Psychiatric Billing

Psychiatrists and traditional medical providers have the most in common in mental health. Psychiatrists must be familiar with mental health CPT and psychiatric diagnostic evaluation codes to bill correctly.

Behavioural Health Billing

Behavioral health billing is similar to psychotherapy billing in many ways, but it focuses on social services. Community social workers, behavioral specialists, and other experts include in behavioral health billing. It can add another layer to consider when coding.

Substance Abuse 

Substance abuse treatment facilities deal with a wide range of highly complex situations. The billing can be challenging due to regulations, laws, and insurance issues. The delicate nature of substance abuse treatment can also present difficulties.

How Do You Bill For Mental Health Services?

Recognize the distinction between ICD-10 and CPT codes

ICD-10 (International Classification of Diseases, 10th revision) and CPT (Current Procedural Terminology) codes require for medical and mental health billing. The latter is essential because ICD-10 codes reveal the patient’s diagnosis, whereas CPT codes demonstrate the diagnosis treatment. You cannot charge payers for a diagnosis, but you can charge them for treatment services. The ICD-10 book contains over 200,000 codes. There are more CPT codes, but most mental health professionals will use the ones that begin with the number 9. These five-digit codes relate to mental health checking, evaluation, psychiatry evaluation and management, case management, and so on. Mainly, the duration of a patient encounter affects the CPT codes you’ll use (which isn’t the case with traditional medical billing). CPT code 90834 denotes a 45- to 55-minute session, while CPT code 90837 denotes anything longer. Correctly coding your services based on length simplifies the procedure.

Learn about the E/M and psychiatric evaluation codes

There are two types of CPT codes that you should be familiar with:

E/M codes: When considering a new patient problem, you’ll use these codes in your billing. Each E/M code necessitates the three paperwork elements listed below.

History: Include the patient’s current diagnosis, system review, and family and social background here.

Exam: In this section, you’ll review the patient’s history, current problems, and the exams you’ve conducted.

Making medical decisions: In this section, you will specify how many definitive diagnoses were given and how many treatment techniques were used during the patient encounter. You’ll also mention any possible complications and describe the patient’s data’s difficulty.

Psychiatric evaluation: If your psychotherapy session contains psychiatric components, you must bill and code it. Notably, any time spent on psychiatric evaluation cannot be deducted from the time spent offering psychotherapy services. For example, if you spend 50 minutes on psychotherapy and 10 minutes on psychiatric evaluation, use CPT code 90834 rather than 90837.

Evaluate the patient’s insurance coverage

 You can start billing by closely associating with the ICD-10, CPT, E/M, and psychiatric evaluation codes that apply to your offerings. Before each patient’s first visit, the first step is verifying benefits (VOB). Take a copy of the patient’s insurance card for this purpose. Then, go to the insurer’s provider portal and see if the patient’s insurance covers your services. If there is no portal available, contact the insurer.

Determine which billing form to use

You will likely see two medical and mental health billing aspects: UB-04 and CMS-1500. Front-office personnel will use the UB-04 form, while professionals will use the CMS-1500.

In either case, keep your National Provider Identifier (NPI) and tax identification number (TIN) helpful. You should also recognize the required information in each form segment, as different payers may have different requirements.

How Does Mental Health Billing Software Make Their Jobs Easier?

As a mental health professional, you know that billing is essential to your business. But what if you could make your job easier and more efficient?

Mental Health Billing Software makes it easy to create professional-looking invoices and bills for insurance companies and patients without spending hours entering data into spreadsheets or typing information into online forms. The best thing about mental health billing software is that it automates much of the work so that there’s less time spent doing repetitive tasks like creating invoices or entering data manually into spreadsheets. With this program, you can save money while helping patients get better care faster by reducing errors in their records!

What Do You Need To Run An Efficient Mental Health Billing Practice?

You need several things to run an efficient mental health billing practice. The first thing you should do is get yourself some mental health billing software and services. There are two types of mental health billing software, one is web-based, and the other is on-premises. The former allows you to create your reports in minutes, while the latter offers more advanced features but comes at a higher price tag than the former option.

You also need mental health billing training to become familiar with what information needs to be included when filing claims for reimbursement purposes and how best practices should follow when doing so. This training should also include tips on how best practices should follow when filing claims for reimbursement purposes, such as using correct terminology or making sure everything is spelt correctly (including punctuation). Finally, suppose your organization has its compliance department. In that case, it will be essential for them to know what steps must be taken before submitting any claim so that no mistakes occur during processing time frames or submission dates themselves!

Following these best practices for mental health billing will make the repetitive process more manageable.

Always perform a VOB

It is impossible to overstate the importance of the VOB process. A few minutes early to confirm your patient’s benefits could save you work hours later. When your clients understand what their health coverage will and will not cover, they are more likely to pay timely payments to you.

Gather a lot of information

There is no such thing as assembling too much data in the mental health billing process. Many details include the patients’ complete legal names and current discussions. This increases your chances of avoiding billing delays.

Take notes both during and after the insurance verification. When payers communicate with you, they assign a reference ID to each discussion and identify the representative with whom you spoke. You must do the same; request the reference ID and the name of your contact. If you need to notify the payer again, you’ll have a history of all the billing stages you’ve taken. This procedure increases accuracy and simplifies future billing.

How Much Do Mental Health Billing Services Cost?

This depends on the size of your practice and how many employees you have. If you have an in-house staff, it may be less than if your practice has several therapists working together. In addition to the cost of the service provider’s time, there is also a fee for using their software platform, which can range from $5,000 to $20,000 per year for smaller practices or up to $50K per year for larger practices. The fees are based on what kind of account management system they provide and other factors like extra features and integrations such as Google Analytics or HIPAA-compliant record-keeping software.


This post has given insights into mental health billing services and what they can do for your practice. Please contact us anytime if you have any questions or want to speak with our team about mental health billing services. We look forward to working with you.

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