Behavioral Health Billing Services for Therapy and Psychiatry Practices
Therapy billing looks repetitive: the same client, the same code, every week. That’s why small mistakes get expensive. A wrong telehealth setting, an authorization that ran out three sessions ago, or a clinician who isn’t in network with the plan managing the mental health benefit can repeat across dozens of claims before anyone sees it. We provide behavioral health billing services to group practices, solo clinicians and psychiatric providers, and our job is to catch those problems early.
What makes behavioral health billing different
Time-based psychotherapy codes
Psychotherapy codes follow documented time: 90832 for 16 to 37 minutes, 90834 for 38 to 52, and 90837 for 53 or more. When a psychiatrist or psychiatric NP provides an E/M service and psychotherapy in one visit, the add-ons 90833, 90836 and 90838 apply, and E/M time can't count toward therapy time. Evaluations (90791, 90792), family therapy (90846, 90847), group therapy (90853), crisis codes (90839, 90840) and interactive complexity (90785) each have their own rules. Some payers watch 90837 closely, so start and stop times matter.
Telehealth coding
POS 02 and POS 10 separate telehealth delivered outside the client's home from telehealth in the home. Payers may also want 95, GT, 93 or FQ, especially for audio-only visits. Medicare's tele-mental health rules, including the in-person visit requirement, have shifted more than once, and Medicaid and commercial plans publish their own policies. A setup that worked last year may not work now.
Authorizations and visit limits
Plenty of plans allow a set number of outpatient sessions before authorization is required. Intensive outpatient, partial hospitalization and psychological testing (96130 to 96139) usually need approval from the start. Tracking remaining visits and end dates for every client is tedious, and one missed date usually means a string of denials.
Carve-out payers
The card might show a major insurer while a separate behavioral health organization manages the mental health benefit. Claims sent to the medical plan come back denied, and a clinician credentialed with the medical plan can still be out of network with the carve-out. Eligibility checks have to confirm who really administers the benefit.
Credentialing by license type
Psychiatrists, psychologists, psychiatric NPs, LCSWs, LPCs or LMHCs, and LMFTs are each credentialed differently, and payer acceptance varies by license and state. Medicare began enrolling marriage and family therapists and mental health counselors in 2024. Billing for pre-licensed associates under a supervisor depends on state law and payer policy, so it has to be checked, not assumed.
Client balances and privacy
Weekly copays and January deductible resets add up fast for clients. Uninsured and self-pay clients must get a good faith estimate under the No Surprises Act. Psychotherapy notes have extra HIPAA protection, and 42 CFR Part 2 programs carry added consent rules, so billing staff should see only what a claim needs.
Our Services
How Salyx RCM helps behavioral health practices
Intake and eligibility
Before the first session, and again at set intervals, we verify eligibility and confirm behavioral health benefits, the carve-out administrator, telehealth coverage, copays and remaining visits.
Authorizations
Outpatient, IOP/PHP and testing authorizations are requested and tracked, and your team hears from us before units or dates run out.
Coding review
Time-based codes, add-ons, telehealth POS and modifiers are checked by certified coders on our coding team against the session note and each payer's policy.
Claim submission
Every claim is scrubbed and sent to the plan that actually manages the benefit, which isn't always the name on the card.
Payment posting
Payments are posted by clinician and location, so you can see how each provider and service line is doing.
AR and denials
Our AR and denial management staff work authorization, eligibility, credentialing and telehealth denials, and point out patterns before they spread across more sessions.
Credentialing
New clinicians, re-credentialing, CAQH upkeep and carve-out enrollment are all part of our credentialing service.
Client statements
Balances in behavioral health need a lighter touch. Our patient statements are clear and respectful, and payment plans are available when clients need them.
Reporting
Reports show AR by payer and clinician, denial reasons, and authorizations that are about to expire.
Your current EHR
We work in systems like SimplePractice, TherapyNotes, Valant and Netsmart, and others, so billing happens inside the EHR your clinicians already chart in. Client records don't have to move to a new platform.
How It Works
Our process
1. Discovery call
We go over your clinicians, payers, telehealth volume and EHR.
2. Payer and credentialing check
We confirm who is in network with which plans, carve-outs included.
3. Onboarding
Access is role-based and limited to the information billing actually needs.
4. Recurring workflow
Eligibility rechecks, authorization tracking, claims and follow-up run on a fixed schedule.
5. Monthly review
Trends, open issues and payer policy changes are reviewed with you each month.
Related reading
Session limits
Re-authorization gaps in recurring care are covered in our post on fixing prior authorization delays at the front end.
Payer conversations
Some payments only come back after a phone call. Read about the human side of revenue cycle management.
Staffing your billing
If you're deciding whether to keep billing in-house, this in-house vs outsourced billing checklist compares cost and control.
Frequently Asked Questions
Common questions from therapists, psychiatric providers and practice managers.
1. Which psychotherapy CPT codes do you bill?
All the outpatient behavioral health codes: 90791 and 90792 evaluations, 90832, 90834 and 90837 psychotherapy, the 90833, 90836 and 90838 add-ons with E/M, family and group therapy, crisis codes and interactive complexity. For each one, we check that the documented time and content support the code.
2. Can you bill telehealth sessions correctly for different payers?
Yes. Place of service and telehealth modifiers are set to each payer’s current policy, including audio-only rules, and we recheck those settings when payers update their policies.
3. What is a carve-out, and why does it cause denials?
A carve-out is when a health plan hands its mental health benefit to a separate behavioral health organization. Claims and credentialing then go to that organization, not the medical plan. We spot carve-outs during eligibility checks so claims reach the right payer.
4. Do you credential LCSWs, LPCs and LMFTs?
Yes, along with LMHCs, psychologists, psychiatric NPs and psychiatrists. We enroll them with commercial, Medicaid, Medicare and carve-out payers, following each payer’s rules for that license type.
5. How do you protect client privacy?
We sign a Business Associate Agreement with each practice before we see any client information. Our processes are HIPAA-compliant, access is role-based, and we limit our work to what’s needed to bill. We don’t need psychotherapy notes to submit claims.
Other specialties we serve
Salyx RCM also handles billing for these related specialties.
Multi-Specialty Billing
E/M leveling, modifiers and global surgery across departments.
Laboratory Billing
Requisitions, medical necessity, CLIA, toxicology and molecular tests.
Sleep Lab Billing
Study codes, home sleep tests and CPAP coverage rules.
Home Health Billing
PDGM coding, NOA timing, LUPA thresholds and signed orders.
Let's talk about your practice
Recurring denials, expired authorizations and credentialing delays are fixable once you know where they start. Tell us what you’re seeing and we’ll review it with you at no cost. Call (321) 788-3655 or email info@salyxrcm.com, whichever is easier.