Specialty billing
Mental Health billing
We code mental and behavioral health to your payer rules, not a generic template, handling time-based psychotherapy, authorizations, and telehealth the way each plan expects.
Where claims slip
Billing considerations for mental health
Common places mental health revenue leaks. We code each of these to your payer rules, not a one-size-fits-all template.
Time-based psychotherapy codes (the 90832 / 90834 / 90837 family) are easy to under- or over-code without clear session timing in the note.
Diagnostic evaluations bill differently from ongoing therapy and follow their own rules.
Many plans require prior authorization for ongoing sessions, and lapses interrupt payment.
Telehealth place-of-service and modifier rules (such as 95) vary by payer and state.
Group and family therapy sessions have distinct codes that are frequently overlooked.
Representative codes
Codes we see in mental health
A few illustrative CPT and HCPCS examples, not an exhaustive or guaranteed list. We code from your documentation and each payer's current rules.
- 90791
- Psychiatric diagnostic evaluation (no medical services)
- 90834
- Psychotherapy, 45 minutes with patient
- 90837
- Psychotherapy, 60 minutes with patient
- 90853
- Group psychotherapy (other than family)
- 90847
- Family psychotherapy with patient present
Illustrative examples for context only. Actual codes depend on documentation, setting, and payer rules, and code sets change over time.
How we help
How our services apply to mental health
The same accountable team handles the work behind your mental health claims. Here is where each service fits.
Common questions
Mental Health billing, answered.
Do you manage session authorizations?
Yes. We track authorization requirements and submit and renew them so a lapsed auth does not interrupt payment for ongoing therapy.
Can you bill telehealth sessions correctly?
We code telehealth with the place-of-service and modifiers each payer and state require, since those rules are not uniform across plans.
How do you choose the right psychotherapy time code?
We code from the documented session time in the note, so the 45- and 60-minute codes are supported by the record rather than assumed.
Ready to bill mental health the right way?
732-209-1487 · info@vertexmedicalbilling.com