No doubt, mental health billing is an important part of a successful practice, but it is not easy for therapists. They find it confusing and stressful as well. Suppose you are a new biller or have been doing it by yourself. In that case, you must know the management of insurance claims, reimbursement rates, and proper coding so that you get compensated fairly and that your patients do not get any unexpected charges.
At Providers Care Billing LLC, we provide efficient medical billing for mental health services. In this blog, we are going to discuss the basics of mental health billing, how to properly bill insurance for therapy, and some valuable tips to make the process easier than ever. For official guidance on behavioral health billing, refer to CMS.gov Behavioral Health
What Makes Mental Health Billing Different from General Medical Billing?
There are many differences between mental health medical billing and general medical billing in many ways. Both involve handling insurance claims and ensuring accurate reimbursement, but billing for therapists needs to pay special attention to mental health care. Learn more about our Medical Billing Services designed for mental health professionals.
For example, different coding systems are made for mental health services, such as ICD-10 codes for mental health disorders. Such codes are more specialized than those for physical ailments. In addition, detailed documentation is a major demand of mental health billing. These documents consist of session notes that give an explanation of the therapeutic procedures and patient progress. After the completion of documents, get ready for accurate billing and reimbursement.
Why is Mental Health Billing Complicated?
Medical billing for mental health services seems much more complex to many therapists and mental health professionals than other medical billing forms. This complexity is mainly due to the following factors:
Diagnosis Codes
It is the need of the therapists to use highly specific codes to describe the mental health conditions they are treating exactly. This coding is not the same for every patient, and sometimes these codes change frequently.
Reimbursement Rates
In contrast to the general medical services, insurance billing for therapists often comes with lower and more variable reimbursement rates. It creates uncertainty in the financial aspects of your practice.
Document Requirements
Insurance companies often ask for documents with detailed session notes, treatment plans, and progress reports to justify the need for therapy. As a result of these documents, mental health billing becomes more time-consuming and paperwork-intensive.
Insurance Policies
There are also some specific limitations or exclusions of mental health care in insurance coverage that make it important to know how to bill insurance for therapy and what to do if there are discrepancies.
Types of Mental Health Services and Their Billing Needs
Mental health care is not the name of a single service; instead, it includes many services. Each service type has its own specific billing for psychology processes. That’s why you must know the different services offered and their corresponding mental health billing codes for proper billing.
The following are some common types of mental health services and their billing needs:
Individual Therapy
One-on-one sessions that mainly focus on personal issues. It is normally billed with CPT codes such as 90834 for a 45-55-minute session.
Group Therapy
It involves sessions with multiple participants, typically billed under codes such as 90853.
Family Therapy
Such therapy gives priority to the family dynamics with the main CPT codes as 90846 (without patient) and 90847 (with patient).
Crisis Intervention
It involves instant support during mental health emergencies and has the CPT code 90839.
Psychiatric Evaluations
It is a detailed assessment that includes diagnosis and treatment planning.
Substance Abuse Counselling
This special kind of therapy is for individuals to manage addiction. Detailed documentation is also necessary here for accurate billing.
Diagnosis Coding for Mental Health Billing
Accurate mental health coding and billing is not possible without diagnosis coding. ICD-10 codes for conditions being treated are an important demand of mental health care services.
Some codes mainly used in mental health billing are as follows:
- F32.1: Major Depressive Disorder, Single Episode, Mild
- F41.9: Anxiety Disorder, Unspecified
- F41.1: Generalized Anxiety Disorder
- F42: Obsessive-Compulsive Disorder
- F32.1: Agoraphobia with Panic Disorder
All these codes make sure that the services rendered are perfectly documented and billed.
Common CPT Codes in Mental Health Services
The right CPT codes (Current Procedural Terminology) are an important thing for billing. Such codes only provide information about the type of service provided and ensure that you and your patients are reimbursed correctly.
Therapy insurance billing mostly uses the following CPT codes:
- 90791: Intake Session (for new patients)
- 90834: 45-55 Minute Individual Therapy
- 90837: 56+ Minute Individual Therapy
- 90846: Family Therapy (without patient present)
- 90847: Family Therapy (with patient present)
- 90853: Group Therapy
- 90839: Psychotherapy for Crisis (60 minutes)
The accurate use of these codes makes medical billing for psychologists a smooth reimbursement process.
How to Submit Claims in Mental Health Billing?
After the completion of your session and the selection of codes, it is time to submit the claim. The claim submission consists of these steps:
Gather Documentation
First of all, you should collect the necessary documents that include session notes, treatment plans, and the appropriate ICD-10 codes and CPT codes.
Complete the Claim Form
You will have to use the CMS-1500 form for outpatient codings. You should also double-check that all the required information is correct.
Submit the Claim
The options for claims submission are both electronic and by mail, according to the insurance company’s preference.
Follow Up
Check your claims’ status and be proactive if there are any denials or requests for more information. It shows that you stay on top of your medical billing for private practice.
When you remain organized and proactive, there is no chance of delays in your therapy insurance billing process.
Who Can Bill for Mental Health Services?
While billing for therapists, different licensed professionals can submit claims such as:
- Licensed Therapists: Psychologists, Licensed Clinical Social Workers, and Licensed Professional Counselors, they can all bill for their services.
- Psychiatrists: Medical doctors can bill for both therapy and managing medication.
- Non-Physician Providers: In some cases, incident-to billing allows non-physician providers to also bill under a physician’s supervision.
- Credentialed Providers: Insurance companies often need credentialed providers to meet the needed standards for reimbursement.
Training and Resources for Mental Health Billing
Mastering mental health medical billing is possible only with proper training. Mental health billing training gives you the skills to deal with the complexities of coding, insurance claims, and reimbursement. At Providers Care Billing LLC, we not only provide training but also give ongoing support to help you understand the ins and outs of billing for psychology.
You will also learn how to bill insurance for therapy. Furthermore, you’ll know about how to handle different billing situations, and get proper guidance on the latest codes and regulations. We promise that our expert support will make you more confident and prepared to handle medical billing for mental health services.
Why Choose Providers Care Billing LLC?
At Providers Care Billing LLC, we know all the challenges of medical billing for private practice and mental health professionals. Our services simplify the billing process and give you time to do your major job, which is caring for patients.
Expert Support
Our team has spent many years in medical billing for mental health services and always commits to accurate and timely reimbursement.
Customized Solutions
We tailor our services for the fulfilment of the demands of each of your practices and streamline your insurance billing for therapists.
Comprehensive Training
We offer mental health billing training so that you have the knowledge and tools to handle every step of your billing processes confidently.
Final Thoughts!
Billing for therapists and medical billing for psychologists should not be as complicated as it is
You can make it easier when you have the right knowledge, tools, and support. In this way, your practice will run smoothly and perfectly. When you just start out or want to manage your existing billing processes, Providers Care Billing LLC is always here to help you with mental health coding and billing.
Now, what are you thinking about? Come on! Let us take the stress out of billing. Reach out today to get more information about our services and learn how we can assist you with insurance billing for therapy!
