BEHAVIORAL HEALTH CLINIC · AR BACKLOG
$1M recovered in 75 days
Targeted denial management and automated claim workflows on an AR backlog.
Read the case study →Medical specialties
Primary and family care
Surgical and procedural
Dental, DME and labs
Revenue cycle · one rate
Front end · before the visit
Patients, insight and growth
Clinical documentation
Revenue operations
Voice automation
Behavioral health billing · Mental health billing services
PhysiAssist runs behavioral health revenue cycle management for psychiatry and medication management, therapy and group practices, SUD, IOP and PHP programs, TMS and Spravato clinics, and sleep medicine. We code add-ons and telehealth the way each payer pays them, work every denial, and can help a new clinic launch and fill its schedule.
Psychotherapy code finder
Try itBill
90834Time band
38–52 minStandalone psychotherapy, 45 minutes. Document start and stop times or total time in the note.
CPT time rules for psychotherapy
The basics
Behavioral health billing services manage the revenue cycle of a mental health or substance use practice: eligibility checks (including carve-out behavioral plans), authorizations and concurrent reviews, coding of evaluations, psychotherapy, add-on codes and E/M, telehealth rules, claim submission, payment posting, denials, AR follow-up and patient billing. Outsourcing it to one behavioral health RCM team keeps clinicians on care instead of claims.
90792 evaluations, E/M with therapy add-ons, and prescriber credentialing by payer.
90832–90838, family 90846–90847, group 90853, crisis and interactive complexity.
Per diem codes, revenue codes, authorizations and concurrent reviews for each level of care.
Session-counted TMS authorizations, Spravato per-milligram billing and monitoring, self-pay workflows.
In-lab and home sleep tests, CPAP and oral appliance claims with compliance tracking.
What we check
Most behavioral health denials come from a handful of rules: time bands, add-ons, telehealth and authorizations. We check them before the claim goes out.
| Codes | What they cover | What we check |
|---|---|---|
| 90791 · 90792 | Psychiatric diagnostic evaluation, without and with medical services | One per patient per day, and who may bill each code under the payer |
| 90832 · 90834 · 90837 | Psychotherapy, 16–37, 38–52 and 53+ minutes | Documented time matches the code; some payers review 90837 more closely |
| 90833 · 90836 · 90838 | Psychotherapy add-ons with a same-day E/M | Therapy time documented apart from the E/M, and the E/M level supported |
| 90846 · 90847 · 90853 · 90785 | Family therapy, group therapy, interactive complexity | Patient present or not, group size notes, and add-on rules |
| POS 02 / 10 · 95 · GT · 93 | Telehealth place of service and modifiers, audio-only | Each payer's own rule, set per plan |
| 90867 · 90868 · 90869 | TMS: first treatment with mapping, later sessions, re-mapping | Session count against the authorization, one first-treatment code per course |
| S0013 · G2082 · G2083 | Esketamine (Spravato) per milligram, and Medicare esketamine visits | Dose units, REMS monitoring documentation and payer-specific codes |
| H0015 · S9480 · H0035 | Substance use IOP, psychiatric IOP, mental health partial hospitalization | Level-of-care authorization, per diem units and concurrent review dates |
| 95810 · 95811 · 95806 · E0601 | In-lab sleep study, CPAP titration, home sleep test, CPAP device | Medical necessity, and CPAP use of 4+ hours on 70% of nights in 30 days for Medicare |
Free claims and denial review
Send us a recent month of claims and your denial list. A behavioral health billing specialist reviews them and sends a written report you keep, whether or not you work with us.
Claims reviewed
1,240Denied or underpaid
96Recoverable
$18,700What the report covers
Results
BEHAVIORAL HEALTH CLINIC · AR BACKLOG
Targeted denial management and automated claim workflows on an AR backlog.
Read the case study →NEW CLINIC LAUNCH · BILLING + MARKETING
We set up payer enrollment, billing and the first claims for a new behavioral health clinic, and ran its digital marketing to fill the schedule.
See the launch story →Opening a new practice?
Enrollment, billing setup, first claims and patient marketing, run by one team. The purple numbers are the targets we work to for a new clinic, not past results.
Entity and NPI checks, CAQH, payer enrollment filed, EHR and fee schedule set, billing rules per payer.
Enrollment filed in week 1Eligibility on every visit, claims out daily, self-pay and out-of-network workflows while enrollments finish.
Claims out within 48 hoursGoogle Business Profile, local search and paid search for the services you want to grow.
New-patient calls tracked weeklyIn-network payments posted, first denials worked to root cause, authorizations tracked.
97%+ clean claimsMore providers enrolled, more appointment slots, marketing tuned to the services that pay.
Denial rate under 5%Monthly KPI review, AR worked by age bucket, a plan for the next six months.
Days in AR under 30CAQH, Medicare, Medicaid and commercial enrollment for psychiatrists, nurse practitioners, psychologists and therapists, including marriage and family therapists and mental health counselors, whom Medicare enrolls since 2024.
Google Business Profile, local search, paid search and a website that books appointments, aimed at the services and payers you want more of.
Where we work
We run billing today for behavioral health clinics in Massachusetts, Arizona and West Virginia. Our team works inside your system, so clinicians keep their workflow.
The systems we work in every day
We log in to your system; nothing about it changes for your team.
Claims, rejections and remittances worked through your clearinghouse.
Submissions, status checks and renewals in each payer's own portal.
Pricing
One rate of 2.8% to 5% of net collections, quoted in writing before you sign. Where you land depends on monthly collections, specialty mix, the scope of services, and your AR backlog and payer mix.
The rate covers medical coding, claim submission, payment posting, denials and AR follow-up. Front desk services, prior authorization, the reporting dashboard, patient statements, credentialing and digital marketing are quoted separately.
Estimate your rate →Eligibility and benefits checks (including carve-out behavioral plans), authorizations and concurrent reviews, coding of evaluations, psychotherapy, add-on codes and E/M, telehealth place-of-service and modifiers, claim submission, payment posting, denial management, AR follow-up and patient billing.
The terms are used interchangeably. Behavioral health usually also covers substance use treatment (SUD, IOP, PHP), while mental health billing often means psychiatry and therapy. We bill all of them.
When a prescriber does psychotherapy on the same day as an E/M visit, the therapy is billed with an add-on code by time: 90833 for 16 to 37 minutes, 90836 for 38 to 52 minutes, and 90838 for 53 minutes or more. Therapy time must be documented separately from the E/M.
Payers differ on the place of service (02 or 10), the modifier (95 or GT), and audio-only visits (modifier 93 or FQ). We keep a rule for each payer and plan, so telehealth claims are built the way that payer pays them.
Yes. TMS is billed with 90867 for the first treatment with motor threshold mapping, 90868 for each later session and 90869 for re-mapping, against an authorization that counts sessions. Spravato is billed with S0013 per milligram plus the monitoring services each payer requires, with the REMS documentation on file.
Yes. We set up payer enrollment, the EHR and billing rules, and the first claims, and we can run digital marketing to fill the schedule. One new clinic we support grew from 10 patients a month in its first month to 100 patients a month by month five.
Yes, as a separate service: CAQH, Medicare, Medicaid and commercial enrollment for psychiatrists, nurse practitioners, psychologists and therapists. Since January 2024 Medicare also enrolls marriage and family therapists and mental health counselors.
PhysiAssist charges 2.8% to 5% of net collections for billing and revenue cycle management, quoted in writing before you sign. Collections volume, services, scope, AR backlog and payer mix decide where you land.
A free claims and denial review by a behavioral health billing specialist, with a written report you keep.
A 30-minute call with someone who bills your specialty every day.
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