Mental Health Billing Services That Let You Focus on Patient Care
Stop losing revenue to denied claims, complex authorizations, and payer-specific rules. Qualified RCM handles every aspect of your behavioral health billing so you can do what you do best — treat your patients.
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Mental Health Billing Is Not Like Regular Medical Billing
Behavioral health providers face a unique set of billing complexities that general medical billers simply don't understand. From distinguishing between 90791 (psychiatric diagnostic evaluation) and 90834 (individual psychotherapy, 38 minutes) to navigating payer-specific authorization requirements for 90837 (53+ minutes), the margin for error is razor-thin.
Add telehealth modifiers, place-of-service codes that change depending on setting, and the constant evolution of Medicare and commercial payer policies — and it's no wonder mental health practices lose up to 25% of their revenue to billing inefficiencies.
Qualified RCM was built specifically to solve this problem. Our team understands the nuances of CPT codes 90791, 90792, 90832, 90834, 90837, 90846, 90847, 90853, 99213-99215, and every other code your practice uses — because mental health billing is all we do.
Challenges That Are Costing Your Practice Revenue
Complex Authorization Requirements
Most payers require prior authorization for specific session lengths and treatment types. Missing a single auth can mean a complete denial — and hours of back-and-forth with insurance companies.
Session Length Coding Errors
Billing 90837 when the session was actually 38 minutes, or using 90834 when documentation supports 90837 — these mismatches are the #1 trigger for audits and recoupment requests.
High Claim Denial Rates
Mental health claims are denied at nearly twice the rate of general medical claims. Without specialized denial management, most providers simply write off these denied claims as lost revenue.
Telehealth Billing Confusion
Post-pandemic telehealth policies keep shifting. Modifier 95, GT, FQ, place-of-service 02 vs 10 — getting it wrong means unpaid claims and compliance risk.
Payer-Specific Rule Variations
Every payer — UnitedHealthcare, Aetna, Cigna, Blue Cross, Medicare, Medicaid — has different rules for mental health billing. Keeping up is a full-time job your practice can't afford.
Time Stolen from Patient Care
On average, mental health providers spend 12-15 hours per week on administrative tasks. That's 15 fewer hours of therapy, psychiatry, and counseling your community could be receiving.
Comprehensive Mental Health Billing Services
Eligibility Verification
We verify patient insurance eligibility and benefits before every appointment — checking coverage limits, copays, deductibles, and mental health-specific benefits so there are no surprises.
Prior Authorization
Our team proactively manages prior authorizations for all required services, tracking approval numbers, session limits, expiration dates, and peer-to-peer review requirements.
Claims Submission
Every claim is scrubbed for accuracy before submission — correct CPT codes, modifiers, place-of-service, diagnosis codes, and units — ensuring a 98%+ clean claim rate.
Payment Posting
ERA and EOB payments are posted accurately within 24 hours, including contractual adjustments, copays, deductibles, and patient responsibility amounts.
Denial Management
We don't just write off denials. Every denied claim is analyzed, corrected, and appealed with proper documentation and timely follow-up to maximize recovery.
AR Follow-Up
Our dedicated AR team works aging reports aggressively — following up on unpaid claims at 30, 60, 90, and 120+ days to prevent revenue from slipping through the cracks.
Provider Credentialing
We handle the entire credentialing process — from initial applications with CAQH and payer enrollment to re-credentialing — so you can start billing without delays.
Patient Billing Support
Professional, compassionate patient statements and billing support that respects the sensitivity of mental health services while ensuring you collect what you're owed.
Reporting & Analytics
Monthly dashboards showing key metrics — collection rates, denial trends, average reimbursement, payer performance — so you always know where your revenue stands.
Built for Behavioral Health. Not Adapted From General Medical Billing.
Most billing companies treat mental health claims the same as a cardiology visit. That approach costs you money. We built Qualified RCM from the ground up to serve psychiatrists, psychologists, therapists, and counselors — and that specialization makes all the difference.
- Deep expertise in mental health CPT codes, E/M codes, and modifier usage
- Dedicated teams assigned to your practice — not a rotating call center
- Proactive authorization tracking that prevents denials before they happen
- Real-time visibility into your revenue cycle through custom reporting
- HIPAA-compliant workflows with secure data handling at every step
- No long-term contracts — we earn your business every month
From Onboarding to Ongoing Optimization
Discovery & Onboarding
We analyze your current billing workflow, identify pain points, review your EHR/PM system, and create a customized transition plan with zero disruption to your practice.
Credentialing & Enrollment
We complete or update your CAQH profile, submit payer enrollment applications, and ensure you're paneled with your target insurance companies — including Medicare and Medicaid.
Charge Capture & Coding
Our team reviews your superbills and encounter notes, applies the correct CPT codes (90791, 90834, 90837, etc.) with proper modifiers, and ensures documentation supports every charge.
Claims Submission & Tracking
Scrubbed claims are submitted electronically within 24 hours of receipt. We track every claim through the payer pipeline and flag anything that stalls.
Payment Posting & Follow-Up
Payments are posted daily. Unpaid claims are followed up at 30/60/90-day intervals. Denials are appealed with supporting documentation within filing deadlines.
Reporting & Optimization
Monthly performance reports with actionable insights. We continuously refine your billing strategy based on denial trends, payer behavior changes, and reimbursement patterns.
Billing Expertise Across Every Mental Health Discipline
Whether you're a solo practitioner or a multi-location group practice, we have the coding knowledge and payer experience to handle your specific specialty's billing requirements.
We work with all major EHR and practice management systems including AdvancedMD, DrChrono, SimplePractice, TheraNest, Valant, CarePaths, and more.
24/7 Book a Free ConsultationFrequently Asked Questions About Mental Health Billing
We handle all mental health and behavioral health CPT codes including:
- 90791 — Psychiatric diagnostic evaluation (without medical services)
- 90792 — Psychiatric diagnostic evaluation (with medical services)
- 90832 — Individual psychotherapy, 30 minutes
- 90834 — Individual psychotherapy, 38 minutes
- 90837 — Individual psychotherapy, 53 minutes
- 90846 — Family psychotherapy (without patient present), 26 minutes
- 90847 — Family psychotherapy (without patient present), 38 minutes
- 90853 — Group psychotherapy
- 99213-99215 — E/M codes for psychiatric medical visits
- 90863 — Pharmacologic management with psychotherapy
- And all associated add-on codes, modifiers, and telehealth codes
Our prior authorization process is proactive and systematic. We verify authorization requirements at the time of eligibility verification — before the patient's first appointment. We track the number of authorized sessions, expiration dates, and any review requirements. When an authorization is nearing its session limit, we initiate the renewal process automatically. If a payer requests peer-to-peer review, we prepare the clinical documentation packet for the provider.
Typical onboarding takes 7-14 business days. This includes credentialing review, EHR/PM system integration, workflow setup, and a test batch of claims to ensure everything flows correctly. We assign a dedicated transition specialist who manages the entire process. Most practices see their first clean claims submitted within the first week, with full revenue cycle management active by the end of the onboarding period.
Yes. We stay current on all telehealth billing regulations for mental health, including the correct use of modifiers (95, GT, FQ), place-of-service codes (02 for telehealth, 10 for telehealth in patient's home), and payer-specific telehealth policies. Since telehealth rules for behavioral health have changed significantly since 2020 and continue to evolve, we maintain an updated payer-by-payer reference guide to ensure your telehealth claims are coded correctly every time.
We work with virtually all EHR and PM systems used in mental health practices, including AdvancedMD, DrChrono, SimplePractice, TheraNest, Valant, CarePaths, TherapyNotes, EHR Your Way, Kareo, CollaborateMD, Office Ally, and others. If your system can generate a CMS-1500 or 837P electronic claim, we can work with it.
We offer a transparent, percentage-based pricing model — you pay a flat percentage of collections, typically ranging from 4% to 7% depending on practice volume, specialty mix, and complexity. There are no setup fees, no hidden costs, no per-claim charges, and no long-term contracts. If we don't collect, you don't pay.
The difference is specialization. A general billing company might correctly submit a 99213 E/M code but struggle with the nuances of whether a session should be billed as 90834 or 90837 based on documented time. They may not know that some payers require separate authorization for family sessions (90846/90847) or that Medicare has specific documentation requirements for psychiatric diagnostic evaluations. Our entire team is trained exclusively in behavioral health billing.
Yes, credentialing is included in our service. We manage the entire process — from creating and maintaining your CAQH profile to submitting enrollment applications with each payer, tracking application status, following up on delays, and handling re-credentialing when it comes due. For new practices, we recommend starting credentialing 90-120 days before your target start date.
Stop Leaving Money on the Table. Start With a Free Revenue Assessment.
We'll review your current billing performance, identify specific areas of revenue leakage, and show you exactly how much more your practice could collect — with no obligation and no pressure.
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